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General NPI Number Information
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NPI Number | 1568195071
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE HEALTH OF GROVELAND LLC
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Dates
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Enumeration Date | 07/03/2022
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Last Update Date | 07/03/2022
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Provider Practice Location Address
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Address Line | 676 W BROAD ST
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City | GROVELAND
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State | FL
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Zip | 34736-2406
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Country | US
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Telephone | 352-236-9823
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Fax | 352-433-4236
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Provider Business Mailing Address
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Address Line | 676 W BROAD ST
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City | GROVELAND
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State | FL
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Zip | 34736-2406
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Country | US
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Telephone | 352-236-9823
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Fax | 352-433-4236
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Authorized Official
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Title or Position | CFO
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Name | JHENELLE LAWSON
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Credential | RN
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Telephone | 954-559-6831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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