Provider Demographics
NPI:1144809047
Name:COMPASSIONATE HOME CARE BY JEN
Entity type:Organization
Organization Name:COMPASSIONATE HOME CARE BY JEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:207-602-9871
Mailing Address - Street 1:2 MAIN ST UNIT 35-207
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3084
Mailing Address - Country:US
Mailing Address - Phone:207-602-9871
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN ST UNIT 35-207
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3084
Practice Address - Country:US
Practice Address - Phone:207-602-9871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health