Healthcare Provider Details

I. General information

NPI: 1619860657
Provider Name (Legal Business Name): COMPASSIONATE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 CENTRAL ST STE 4
LOWELL MA
01852-2236
US

IV. Provider business mailing address

210 AMESBURY ST
DRACUT MA
01826-5648
US

V. Phone/Fax

Practice location:
  • Phone: 978-662-1056
  • Fax:
Mailing address:
  • Phone: 978-662-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: RAHIMETOU MBOUOMBOUO
Title or Position: PMHNP
Credential:
Phone: 978-662-1056