Healthcare Provider Details

I. General information

NPI: 1508611211
Provider Name (Legal Business Name): COMPASSIONATE CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 14TH AVE E STE 203A
WEST FARGO ND
58078-3363
US

IV. Provider business mailing address

1042 14TH AVE E STE 203A
WEST FARGO ND
58078-3363
US

V. Phone/Fax

Practice location:
  • Phone: 701-979-2310
  • Fax:
Mailing address:
  • Phone: 701-979-2310
  • 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 Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DOMINICK GAUDIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 701-729-2370