Healthcare Provider Details

I. General information

NPI: 1578579892
Provider Name (Legal Business Name): COMPASSIONATE SENIOR CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S MICHIGAN AVE
HOWELL MI
48843-2214
US

IV. Provider business mailing address

203 S MICHIGAN AVE
HOWELL MI
48843-2214
US

V. Phone/Fax

Practice location:
  • Phone: 517-545-5500
  • Fax:
Mailing address:
  • Phone: 517-545-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberE140465792012
License Number StateMI

VIII. Authorized Official

Name: MR. KEVIN THOMAS EVELY
Title or Position: OWNER
Credential:
Phone: 517-545-5500