Healthcare Provider Details

I. General information

NPI: 1457116840
Provider Name (Legal Business Name): COMPASSIONATE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10903 STONEBROOK TERRACE DR
TOMBALL TX
77375-0070
US

IV. Provider business mailing address

10903 STONEBROOK TERRACE DR
TOMBALL TX
77375-0070
US

V. Phone/Fax

Practice location:
  • Phone: 832-732-0973
  • Fax:
Mailing address:
  • Phone: 832-732-0973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: AYAN ISSE
Title or Position: ADMINISTRATOR
Credential:
Phone: 832-732-0973