Healthcare Provider Details

I. General information

NPI: 1578362588
Provider Name (Legal Business Name): COMPASSIONATE CONNECTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/16/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 W 1ST AVE
CRESTVIEW FL
32536-2455
US

IV. Provider business mailing address

20543 OLD SPANISH TRL
NEW ORLEANS LA
70129-2627
US

V. Phone/Fax

Practice location:
  • Phone: 850-879-7527
  • Fax: 850-879-7527
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY BATES
Title or Position: OWNER
Credential:
Phone: 850-879-7527