Healthcare Provider Details

I. General information

NPI: 1063852648
Provider Name (Legal Business Name): COMPASSIONATE HOME HEALTH AND TRANSPORTATION AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19310 NADOL DR
SOUTHFIELD MI
48075-5827
US

IV. Provider business mailing address

19310 NADOL DR
SOUTHFIELD MI
48075-5827
US

V. Phone/Fax

Practice location:
  • Phone: 313-575-9683
  • Fax:
Mailing address:
  • Phone: 313-575-9683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number StateMI

VIII. Authorized Official

Name: ANGELA NORMAN
Title or Position: OWNER
Credential:
Phone: 313-575-9683