Provider Demographics
NPI:1770303489
Name:COMPANION CARE HOME HEALTH LLC
Entity type:Organization
Organization Name:COMPANION CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-294-0274
Mailing Address - Street 1:410 OAK HILL TER
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1309
Mailing Address - Country:US
Mailing Address - Phone:805-294-0274
Mailing Address - Fax:
Practice Address - Street 1:410 OAK HILL TER
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-1309
Practice Address - Country:US
Practice Address - Phone:805-294-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care