# KOMPANION HOMES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538870902
- **Authorized official:** ANTHONIE D JACKSON (OWNER)
- **Authorized official phone:** (216) 466-1379

## Contact information

- **Practice address:** 1470 E 173RD ST, CLEVELAND, OH 44110-2931
- **Practice address phone:** (216) 466-1379
- **Mailing address:** 1470 E 173RD ST, CLEVELAND, OH 44110-2931
- **Mailing address phone:** (216) 466-1379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | — | — |
| 376J00000X | Homemaker | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2022
- **Last updated:** 11/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2910854 | — | OH |