Provider Demographics
NPI:1982237210
Name:CHRISTYS COMPASSIONATE CARE LLC
Entity Type:Organization
Organization Name:CHRISTYS COMPASSIONATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:NANYONGO
Authorized Official - Last Name:AYUKESONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-860-1692
Mailing Address - Street 1:13205 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3602
Mailing Address - Country:US
Mailing Address - Phone:301-860-1692
Mailing Address - Fax:
Practice Address - Street 1:13205 4TH ST
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3602
Practice Address - Country:US
Practice Address - Phone:301-860-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health