Provider Demographics
NPI:1154768646
Name:A COMPASSIONATE HEALTHCARE LLC
Entity type:Organization
Organization Name:A COMPASSIONATE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMENISTRETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARIFA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WAHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-234-9088
Mailing Address - Street 1:9745 MONTCLAIR HEIGHTS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-7509
Mailing Address - Country:US
Mailing Address - Phone:702-234-9088
Mailing Address - Fax:
Practice Address - Street 1:6180 W.VIKING RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178
Practice Address - Country:US
Practice Address - Phone:702-234-9088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20121335447253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care