MEDICARE: COMPASSIONATE IN-HOME CARE 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	253J00000X	Foster Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902781784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE IN-HOME CARE LLC

Provider Business Mailing Address
First Line	:	8104 E INDIANA AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-2415
Country	:	US
Telephone Number	:	508-942-8147
Fax Number	:

Provider Business Practice Location Address
First Line	:	8104 E INDIANA AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99212-2415
Country	:	US
Telephone Number	:	508-942-8147
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANASTASIA W NDEGWA
Credential	:
Telephone Number	:	508-942-8147

Provider Enumeration Date	:	08/09/2025
Last Update Date	:	08/09/2025

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