Provider Demographics
NPI:1548955032
Name:COMPASSIONATE SERVICES, LLC
Entity type:Organization
Organization Name:COMPASSIONATE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHODRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BONGAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-519-0215
Mailing Address - Street 1:1 N CHARLES ST STE 1904
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-3727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 N CHARLES ST STE 1904
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-3727
Practice Address - Country:US
Practice Address - Phone:323-519-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health