Healthcare Provider Details

I. General information

NPI: 1992229942
Provider Name (Legal Business Name): A COMPASSIONATE IN-HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W HAYCRAFT AVE STE B1
COEUR D ALENE ID
83815-8104
US

IV. Provider business mailing address

411 W HAYCRAFT AVE STE B1
COEUR D ALENE ID
83815-8104
US

V. Phone/Fax

Practice location:
  • Phone: 208-930-1871
  • Fax:
Mailing address:
  • Phone: 89-301-8712
  • Fax: 208-930-1877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TARA J MCAVOY
Title or Position: EXECUTIVE ADMINISTRATOR-BOOKKEEPER
Credential:
Phone: 208-518-7311