Provider Demographics
NPI:1063586832
Name:COMPASSIONATE HOME HEALTH AGENCY
Entity type:Organization
Organization Name:COMPASSIONATE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OBIOMA
Authorized Official - Middle Name:I
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:734-717-6064
Mailing Address - Street 1:42000 KOPPERNICK RD
Mailing Address - Street 2:SUITE A-15
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4282
Mailing Address - Country:US
Mailing Address - Phone:737-717-6064
Mailing Address - Fax:734-254-0180
Practice Address - Street 1:42000 KOPPERNICK RD
Practice Address - Street 2:SUITE A-15
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4282
Practice Address - Country:US
Practice Address - Phone:737-717-6064
Practice Address - Fax:734-254-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID.