Healthcare Provider Details

I. General information

NPI: 1396568937
Provider Name (Legal Business Name): COMPASSIONATE CARETAKERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32285 GLEN CV APT 8
FARMINGTON HILLS MI
48334-3662
US

IV. Provider business mailing address

32285 GLEN CV APT 8
FARMINGTON HILLS MI
48334-3662
US

V. Phone/Fax

Practice location:
  • Phone: 734-545-9575
  • Fax:
Mailing address:
  • Phone: 734-545-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ABDULLAH AL-RABBAT
Title or Position: CEO
Credential:
Phone: 734-545-9575