Healthcare Provider Details

I. General information

NPI: 1356920326
Provider Name (Legal Business Name): COMPANION CARE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/20/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 S FEDERAL HWY
DELRAY BEACH FL
33483-3227
US

IV. Provider business mailing address

20120 ROUTE 19 STE 205
CRANBERRY TWP PA
16066-6210
US

V. Phone/Fax

Practice location:
  • Phone: 412-376-7636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: JACOB ROBINSON
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 330-853-9214