Healthcare Provider Details

I. General information

NPI: 1275458002
Provider Name (Legal Business Name): COMPASSIONATE CARE COMMUNITY NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 RUDD ST
BURLINGTON NC
27217-2960
US

IV. Provider business mailing address

510 RUDD ST
BURLINGTON NC
27217-2960
US

V. Phone/Fax

Practice location:
  • Phone: 336-214-3512
  • Fax:
Mailing address:
  • Phone: 336-214-3512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: CINDY L CAMPBELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 336-214-3512