MEDICARE: COMPASSIONATE CARE SERVICES

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1679124028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CARE SERVICES

Provider Business Mailing Address
First Line	:	6720 E STATE BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-7762
Country	:	US
Telephone Number	:	317-460-8801
Fax Number	:	574-334-1135

Provider Business Practice Location Address
First Line	:	5812 W HILLS RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-6358
Country	:	US
Telephone Number	:	317-460-8801
Fax Number	:	574-334-1135

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MAYOKUN ADEYALE
Credential	:	OWNER
Telephone Number	:	317-460-8801

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	07/17/2024

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Directions to “COMPASSIONATE CARE SERVICES ” Practice Location

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