Provider Demographics
NPI:1386309128
Name:COMPASSIONATE HEALTHCARE LLC
Entity type:Organization
Organization Name:COMPASSIONATE HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTUS
Authorized Official - Middle Name:G
Authorized Official - Last Name:WRAYEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-598-7615
Mailing Address - Street 1:3300 COUNTY ROAD 10 STE 5518D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3072
Mailing Address - Country:US
Mailing Address - Phone:612-598-7615
Mailing Address - Fax:
Practice Address - Street 1:3300 COUNTY ROAD 10 STE 5518D
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3072
Practice Address - Country:US
Practice Address - Phone:612-598-7615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-06
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty