MEDICARE: COMPASSIONATE CARE CENTER 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	261QM0850X	Adult Mental Health Clinic/Center	MD418065	PA

General Provider Information

NPI Number	:	1518130335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CARE CENTER LLC

Provider Business Mailing Address
First Line	:	10151 BUSTLETON AVE
Second Line	:	UNIT C
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-3718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10151 BUSTLETON AVE
Second Line	:	UNIT C
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-3718
Country	:	US
Telephone Number	:	215-676-6393
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. POLINA STOLYAROVA
Credential	:
Telephone Number	:	215-676-6393

Provider Enumeration Date	:	04/13/2008
Last Update Date	:	04/13/2008

Similar Medicare Providers

1750354783 — DR. MARSHALL KEITH GARDNER D.O.
Practice Location Address:

10151 BUSTLETON AVE , # D
PHILADELPHIA, PA
19116-3718

Practice Phone: 215-969-3013
Practice Fax:

1043228216 — POLINA STOLYAROVA M.D.
Practice Location Address:

10151 BUSTLETON AVE , UNIT C
PHILADELPHIA, PA
19116-3718

Practice Phone: 215-676-6393
Practice Fax: 215-676-6395

1346853355 — LAUREN DATTILO
Practice Location Address:

10175 BUSTLETON AVE
PHILADELPHIA, PA
19116-3718

Practice Phone: 267-753-0648
Practice Fax:

1639808785 — MR. LOUIS ACKELSBERG LSW
Practice Location Address:

10175 BUSTLETON AVE
PHILADELPHIA, PA
19116-3718

Practice Phone: 215-400-3100
Practice Fax:

1588385736 — JESSICA HENDERSON CROSS LCSW
Practice Location Address:

10175 BUSTLETON AVE
PHILADELPHIA, PA
19116-3718

Practice Phone: 215-400-3100
Practice Fax:

1669470449 — MITCHELL A SCHWARTZMAN D.O.
Practice Location Address:

6122 TORRESDALE AVE
PHILADELPHIA, PA
19135-3718

Practice Phone: 215-338-6677
Practice Fax: 215-338-9935

Directions to “COMPASSIONATE CARE CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.