MEDICARE: COMPASSIONATE HANDS HOME CARE 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	343900000X	Non-emergency Medical Transport (VAN)
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1255044137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE HANDS HOME CARE LLC

Provider Business Mailing Address
First Line	:	445 CRITTENDEN AVE LOWR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-2897
Country	:	US
Telephone Number	:	623-216-0247
Fax Number	:	419-406-4569

Provider Business Practice Location Address
First Line	:	445 CRITTENDEN AVE LOWR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-2897
Country	:	US
Telephone Number	:	623-216-0247
Fax Number	:	419-406-4569

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS/CEO
Name	:	MISS YULONDA BLATHERS
Credential	:
Telephone Number	:	623-216-0247

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	12/23/2023

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