MEDICARE: COMPASSIONATE HOLDINGS 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	:	1619420007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE HOLDINGS LLC

Provider Business Mailing Address
First Line	:	10298 BRANGUS RD
Second Line	:
City	:	DRIFTWOOD
State	:	TX
Zip	:	78619-4398
Country	:	US
Telephone Number	:	512-656-5925
Fax Number	:

Provider Business Practice Location Address
First Line	:	13625 POND SPRINGS RD STE 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78729-4400
Country	:	US
Telephone Number	:	512-872-6030
Fax Number	:	512-872-2779

Authorized Official
Title or Position	:	PRESIDENT/ADMINISTRATOR
Name	:	MR. SCOTT T DUPUIE
Credential	:
Telephone Number	:	512-656-5925

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	08/02/2016

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