MEDICARE: COMPASSION4U CARE MANAGEMENT, PLLC

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1447023924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSION4U CARE MANAGEMENT, PLLC

Provider Business Mailing Address
First Line	:	910 S 8TH ST STE 121
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-6700
Country	:	US
Telephone Number	:	678-799-1626
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 S 8TH ST STE 121
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-6700
Country	:	US
Telephone Number	:	678-799-1626
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ELSUNASSERWOLTH WINSTEAD
Credential	:
Telephone Number	:	678-799-1626

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/06/2023

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