MEDICARE: COMPASSIONATE SUPPORT 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1265229025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE SUPPORT HOME CARE LLC

Provider Business Mailing Address
First Line	:	13747 MONTFORT DR STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4488
Country	:	US
Telephone Number	:	972-861-2713
Fax Number	:

Provider Business Practice Location Address
First Line	:	13747 MONTFORT DR STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4488
Country	:	US
Telephone Number	:	972-861-2713
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	KRISTINA MCCRAY
Credential	:
Telephone Number	:	214-766-2922

Provider Enumeration Date	:	04/23/2025
Last Update Date	:	09/25/2025

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