Provider Demographics
NPI:1548263197
Name:COMPASSIONATE CARE HOSPICE LLC
Entity type:Organization
Organization Name:COMPASSIONATE CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-948-4357
Mailing Address - Street 1:618 NW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7343
Mailing Address - Country:US
Mailing Address - Phone:405-948-4357
Mailing Address - Fax:405-605-2276
Practice Address - Street 1:618 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-7343
Practice Address - Country:US
Practice Address - Phone:405-948-4357
Practice Address - Fax:405-605-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4148251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK371609Medicare ID - Type UnspecifiedHOSPICE