MEDICARE: COMPASSIONATE CARE GIVERS, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1326365966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CARE GIVERS, LLC

Provider Business Mailing Address
First Line	:	3795 GLENWOOD RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44121-1605
Country	:	US
Telephone Number	:	216-712-8509
Fax Number	:

Provider Business Practice Location Address
First Line	:	3795 GLENWOOD RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44121-1605
Country	:	US
Telephone Number	:	216-712-8509
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANDREA N BROWN
Credential	:
Telephone Number	:	216-712-8509

Provider Enumeration Date	:	04/21/2010
Last Update Date	:	04/21/2010

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