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General NPI Number Information
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NPI Number | 1346870763
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE CARE AT HOME, LLC
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-755-8910
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 SCENIC HWY S
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-755-8910
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CLARISSE KEHOU
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Credential | LPN
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Telephone | 678-755-8910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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