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General NPI Number Information
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NPI Number | 1861153231
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Entity Type | Organization
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Legal Business Name | COMMUNITY COMPASSION CARE, LLC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2965 S JONES BLVD STE E1
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City | LAS VEGAS
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State | NV
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Zip | 89146-5606
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Country | US
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Telephone | 725-696-9982
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Fax | 702-442-8622
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Provider Business Mailing Address
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Address Line | 2965 S JONES BLVD STE E
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City | LAS VEGAS
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State | NV
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Zip | 89146-5606
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Country | US
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Telephone | 725-696-9982
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | AQUANATTE MONIQUE JACKSON
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Credential | LCSW
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Telephone | 725-696-9982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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