Provider Demographics
NPI:1073312278
Name:COMPASSIONATE LIVING PARTNERS LLC
Entity type:Organization
Organization Name:COMPASSIONATE LIVING PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:GYABAAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-422-7987
Mailing Address - Street 1:1437 BRAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-1042
Mailing Address - Country:US
Mailing Address - Phone:240-422-7987
Mailing Address - Fax:
Practice Address - Street 1:618 LAKE DR
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138-9565
Practice Address - Country:US
Practice Address - Phone:240-422-7987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities