Healthcare Provider Details

I. General information

NPI: 1053161117
Provider Name (Legal Business Name): COMPASSIONATE IN HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2024
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8688 E RAINTREE DR APT 4060
SCOTTSDALE AZ
85260-0026
US

IV. Provider business mailing address

8688 E RAINTREE DR APT 4060
SCOTTSDALE AZ
85260-0026
US

V. Phone/Fax

Practice location:
  • Phone: 402-802-5846
  • Fax: 402-922-7327
Mailing address:
  • Phone: 402-802-5846
  • Fax: 402-922-7327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ASIA ALI
Title or Position: OWNER
Credential:
Phone: 402-802-5846