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General NPI Number Information
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NPI Number | 1750834669
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE NURSING AND HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 4384 STAGE RD STE. 301
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City | MEMPHIS
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State | TN
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Zip | 38128
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Country | US
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Telephone | 901-453-6365
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Fax | 901-453-6378
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Provider Business Mailing Address
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Address Line | 4384 STAGE RD 301
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City | MEMPHIS
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State | TN
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Zip | 38128-5794
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Country | US
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Telephone | 901-453-6365
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Fax | 901-453-6378
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | TENESIA NICOLE MOORE
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Credential | R.N.
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Telephone | 901-453-6365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 160001575
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License Number State | TN
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