Provider Demographics
NPI:1326366170
Name:COMPASSIONATE HOME AND HOSPICE CARE, LLC
Entity type:Organization
Organization Name:COMPASSIONATE HOME AND HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FROM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:414-574-1373
Mailing Address - Street 1:2375 S 56TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53219-2213
Mailing Address - Country:US
Mailing Address - Phone:414-574-1373
Mailing Address - Fax:414-434-1981
Practice Address - Street 1:2375 S 56TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53219-2213
Practice Address - Country:US
Practice Address - Phone:414-574-1373
Practice Address - Fax:414-434-1981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI312287-031251J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1861536229Medicare PIN