Healthcare Provider Details

I. General information

NPI: 1518439041
Provider Name (Legal Business Name): COMPASSIONATE HEARTS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 1/2 NORTHGATE RD
NATCHEZ MS
39120-9161
US

IV. Provider business mailing address

125 FIRST ST N
WIGGINS MS
39577-3342
US

V. Phone/Fax

Practice location:
  • Phone: 601-514-9720
  • Fax:
Mailing address:
  • Phone: 601-304-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRAMOND COLENBERG
Title or Position: OWNER
Credential:
Phone: 601-304-2000