Provider Demographics
NPI:1396507729
Name:COMPASSIONATE BRIDGED CARE SERVICES LLC
Entity type:Organization
Organization Name:COMPASSIONATE BRIDGED CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADUMO
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:JAMAL BABA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:605-951-2814
Mailing Address - Street 1:102 N KROHN PL STE 215
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-1847
Mailing Address - Country:US
Mailing Address - Phone:605-951-2814
Mailing Address - Fax:
Practice Address - Street 1:102 N KROHN PL STE 215
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-1847
Practice Address - Country:US
Practice Address - Phone:605-951-2814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASSIONATE BRIDGED CARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-30
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities