Provider Demographics
NPI:1386481711
Name:COMPASSIONATE HEART LLC
Entity type:Organization
Organization Name:COMPASSIONATE HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEESICA
Authorized Official - Middle Name:FAVORED
Authorized Official - Last Name:ADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-993-3586
Mailing Address - Street 1:735 POTOMAC RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-1430
Mailing Address - Country:US
Mailing Address - Phone:347-993-3586
Mailing Address - Fax:
Practice Address - Street 1:735 POTOMAC RIVER RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-1430
Practice Address - Country:US
Practice Address - Phone:347-993-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health