Healthcare Provider Details

I. General information

NPI: 1043611692
Provider Name (Legal Business Name): AMERICAN COMPASSIONATE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5583 DAY RD
CINCINNATI OH
45252-1825
US

IV. Provider business mailing address

5583 DAY RD
CINCINNATI OH
45252-1825
US

V. Phone/Fax

Practice location:
  • Phone: 310-409-3129
  • Fax: 513-741-1354
Mailing address:
  • Phone: 310-409-3129
  • Fax: 513-741-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALYSA ALEXIS CROXTON
Title or Position: OWNER
Credential:
Phone: 310-409-3129