Organization
COMPASSIONATE PROFESSIONAL HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRISSE DAVIS (OWNER)
(912) 677-2143
Entity
Organization
Contact information
Practice address
527 US HIGHWAY 80 W # C102, GARDEN CITY, GA 31408-3115
(912) 677-2143
Mailing address
527 US HIGHWAY 80 W # C102, GARDEN CITY, GA 31408-3115
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
N/A
GA
Enumeration date
05/15/2020
Last updated
12/11/2020
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