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COMPASSIONATE CAREGIVER INC

Nursing & Custodial Care Facilities Assisted Living Facility Assisted Living, Mental Illness

Provider NPI: 1023268570

Organization Information:
Organization Name:  COMPASSIONATE CAREGIVER INC
Organization is not Subpart
Authorized Official:  GLORIA ANN MILLER  ADMINISTRATOR  904-398-0734

Practice Location:
2217 PERRY PL  JACKSONVILLE, FL 32207-3465 US
Tel: 904-398-0734  Fax: 904-398-0734

Business Mailing Address:
2217 PERRY PL  JACKSONVILLE, FL 32207-3465 US
Tel: 904-398-0734  Fax: 904-398-0734

NPI Information:
NPI: 1023268570
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3104A0625XNursing & Custodial Care Facilities
Assisted Living Facility
Assisted Living, Mental Illness
FLAL11371

Other Provider Identifiers:

IssuerNumberStateType
MEDICAID WAVIER PROVIDER6930506 96FL01



American Medical Association 2012 taxonomy code information

Code: 3104A0625X

Type:

Classification:



Definition:



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