# CARE COMPANION AT HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Care Companion At Home LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134821416
- **Authorized official:** KENLEY PAYNE (CO-OWNER)
- **Authorized official phone:** (601) 549-2135

## Contact information

- **Practice address:** 225 GENERAL ROBERT E BLOUNT DRIVE, BASSFIELD, MS 39421
- **Practice address phone:** (601) 606-0784
- **Mailing address:** 16B HEARTWOOD PL, HATTIESBURG, MS 39402-9088
- **Mailing address phone:** (601) 549-2135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 164W00000X | Licensed Practical Nurse | — | NULL | — |
| 164W00000X | Licensed Practical Nurse | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |
| 385HR2055X | Child Mental Illness Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 03/20/2023
- **Last updated:** 03/20/2023