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General NPI Number Information
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NPI Number | 1710572193
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE FAMILY CARE LLC
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Dates
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Enumeration Date | 03/07/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 44131 W KRAMER LN
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City | MARICOPA
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State | AZ
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Zip | 85138-8467
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Country | US
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Telephone | 414-267-7196
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Fax |
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Provider Business Mailing Address
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Address Line | 3898 E LESLIE DR
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City | GILBERT
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State | AZ
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Zip | 85296-2865
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Country | US
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Telephone | 414-267-7196
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY FULTON
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Credential | RN
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Telephone | 414-267-7196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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