Provider Demographics
NPI:1104102870
Name:COMPASSIONATE HOMECARE LLC
Entity type:Organization
Organization Name:COMPASSIONATE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:KIMARU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:800-991-6596
Mailing Address - Street 1:425 UNION ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4115
Mailing Address - Country:US
Mailing Address - Phone:413-732-0001
Mailing Address - Fax:413-732-0018
Practice Address - Street 1:425 UNION ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4115
Practice Address - Country:US
Practice Address - Phone:413-732-0001
Practice Address - Fax:413-732-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110089462AMedicaid
MA110089462AMedicaid