MEDICARE: COMPASSIONATE INNOVATIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104429737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE INNOVATIONS LLC

Provider Business Mailing Address
First Line	:	147 21ST ST NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-3907
Country	:	US
Telephone Number	:	330-844-2814
Fax Number	:	330-880-0333

Provider Business Practice Location Address
First Line	:	3154 LINCOLN WAY NW
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44647-5207
Country	:	US
Telephone Number	:	330-844-2814
Fax Number	:	330-880-0333

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY L ZINK
Credential	:
Telephone Number	:	330-844-2814

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	11/17/2020

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