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General NPI Number Information
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NPI Number | 1497939854
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Entity Type | Organization
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Legal Business Name | COMPASSION HEALTHCARE LLC
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 2501 NORTH ST
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City | BEAUMONT
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State | TX
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Zip | 77702-1622
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Country | US
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Telephone | 409-212-1579
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Fax | 409-832-4453
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Provider Business Mailing Address
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Address Line | 2501 NORTH ST
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City | BEAUMONT
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State | TX
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Zip | 77702-1622
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Country | US
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Telephone | 409-212-1579
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Fax | 409-832-4453
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | ALLEN DAVID AYRES
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Credential | RN
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Telephone | 409-212-1579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 011554
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License Number State | TX
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