Healthcare Provider Details

I. General information

NPI: 1821923475
Provider Name (Legal Business Name): NINA'S COMPASSIONATE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 JENNINGS AVE
BENTON HARBOR MI
49022-5806
US

IV. Provider business mailing address

1412 JENNINGS AVE
BENTON HARBOR MI
49022-5806
US

V. Phone/Fax

Practice location:
  • Phone: 269-759-4608
  • Fax:
Mailing address:
  • Phone: 269-759-4608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: SHAMIKA MASON
Title or Position: OWNER
Credential: CNA
Phone: 269-759-4608