Provider Demographics
NPI:1396324950
Name:COUNTRY CARE COMPANIONS LLC
Entity type:Organization
Organization Name:COUNTRY CARE COMPANIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRYX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-623-2449
Mailing Address - Street 1:PO BOX 2935
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-2935
Mailing Address - Country:US
Mailing Address - Phone:970-623-2449
Mailing Address - Fax:
Practice Address - Street 1:832 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-2221
Practice Address - Country:US
Practice Address - Phone:970-623-2449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care