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General NPI Number Information
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NPI Number | 1316114168
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE CARE NR, LLC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 12040 SOUTH JOG RD. SUITE 8
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City | BOYNTON BEACH
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State | FL
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Zip | 33437
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Country | US
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Telephone | 561-244-5098
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Fax | 561-244-5486
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Provider Business Mailing Address
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Address Line | 12040 SOUTH JOG RD. SUITE 8
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City | BOYNTON BEACH
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State | FL
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Zip | 33437
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Country | US
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Telephone | 561-244-5098
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Fax | 561-244-5486
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LORI A KIANKA
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Credential |
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Telephone | 561-244-5098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | NR30211329
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License Number State | FL
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