Healthcare Provider Details

I. General information

NPI: 1932727005
Provider Name (Legal Business Name): COMPASSIONATE CARE HOME HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7570 OLD CANTON RD STE 203
MADISON MS
39110-6100
US

IV. Provider business mailing address

242 W NORTH ST
CANTON MS
39046-3723
US

V. Phone/Fax

Practice location:
  • Phone: 601-213-8890
  • Fax:
Mailing address:
  • Phone: 601-213-8890
  • 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 Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONI L WRIGHT-YOUNG
Title or Position: OWNER
Credential: REGISTERED NURSE
Phone: 601-213-8890