Healthcare Provider Details

I. General information

NPI: 1740953033
Provider Name (Legal Business Name): COMPASSIONATE FAMILY AND INDIVIDUAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2021
Last Update Date: 08/01/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 MIDWAY
WOODMERE NY
11598-1549
US

IV. Provider business mailing address

941 MIDWAY
WOODMERE NY
11598-1549
US

V. Phone/Fax

Practice location:
  • Phone: 347-650-9476
  • Fax:
Mailing address:
  • Phone: 347-650-9476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: TY G HOPKINS
Title or Position: CEO
Credential:
Phone: 347-650-9476