Provider Demographics
NPI:1669157814
Name:COMPASSIONATE SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:COMPASSIONATE SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-617-4913
Mailing Address - Street 1:30454 ISLAND CLUB DR
Mailing Address - Street 2:
Mailing Address - City:DEER ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32778-9037
Mailing Address - Country:US
Mailing Address - Phone:352-617-4913
Mailing Address - Fax:407-550-8031
Practice Address - Street 1:32 E MAGNOLIA AVE UNIT A
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-3482
Practice Address - Country:US
Practice Address - Phone:352-617-4914
Practice Address - Fax:407-550-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services