1093231276 NPI number — COMPASSIONATE HOME HEALTH LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093231276 NPI number — COMPASSIONATE HOME HEALTH LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASSIONATE HOME HEALTH LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMPASSIONATE HOME HEALTH, LTD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093231276
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4403 CHEVAL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95747-6369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-677-7193
Provider Business Mailing Address Fax Number:
916-677-1729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 MELODY LANE
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95678
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-757-4689
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2017

Additional Information

Authorized Official

Authorized Official Last Name:
APIN-OBERMAN
Authorized Official First Name:
LUISA NORMA
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO/COO/FOUNDER
Authorized Official Telephone Number:
916-677-1711

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1093231276 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1922324938 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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