Provider Demographics
NPI:1710750526
Name:COMPASSIONATE CARING HOME CARE D9 INC
Entity type:Organization
Organization Name:COMPASSIONATE CARING HOME CARE D9 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUSTUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-900-3334
Mailing Address - Street 1:3107 W HALLANDALE BEACH BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5144
Mailing Address - Country:US
Mailing Address - Phone:954-358-2170
Mailing Address - Fax:954-358-2172
Practice Address - Street 1:3107 W HALLANDALE BEACH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HALLANDALE
Practice Address - State:FL
Practice Address - Zip Code:33009-5144
Practice Address - Country:US
Practice Address - Phone:954-358-2170
Practice Address - Fax:954-358-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care