Provider Demographics
NPI:1093520165
Name:EMMANUEL COMPASSIONATE CARE, LLC
Entity type:Organization
Organization Name:EMMANUEL COMPASSIONATE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATALINA
Authorized Official - Middle Name:G
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-410-9972
Mailing Address - Street 1:606 CHARLESTON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2110
Mailing Address - Country:US
Mailing Address - Phone:512-410-9972
Mailing Address - Fax:
Practice Address - Street 1:606 CHARLESTON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2110
Practice Address - Country:US
Practice Address - Phone:512-410-9972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities