MEDICARE: NORTHRIDGE COMPASSION 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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1306781794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHRIDGE COMPASSION CARE, LLC

Provider Business Mailing Address
First Line	:	9208 N SEMINOLE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6087
Country	:	US
Telephone Number	:	509-850-7442
Fax Number	:	509-934-1668

Provider Business Practice Location Address
First Line	:	9208 N SEMINOLE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6087
Country	:	US
Telephone Number	:	509-850-7442
Fax Number	:	509-934-1668

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EDDOE VO
Credential	:
Telephone Number	:	509-507-1430

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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