MEDICARE: COMPASSIONATE SUPPORT SERVICES 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	385H00000X	Respite Care
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care

General Provider Information

NPI Number	:	1578401006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	170 IVYWOOD LN
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-8349
Country	:	US
Telephone Number	:	910-779-8075
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 IVYWOOD LN
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-8349
Country	:	US
Telephone Number	:	910-779-8075
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATOYA WHITTINGTON
Credential	:
Telephone Number	:	910-779-8075

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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