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25D2280573 CLIA NUMBER - CARE COMPANION AT HOME LLC

Laboratory Demographics

CLIA Number: 25D2280573

Facility Name: CARE COMPANION AT HOME LLC

Facility Address:
225 GENERAL ROBERT E BLOUNT DR
BASSFIELD, MS
ZIP 39421
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Facility Phone Number: 601 606-0784

Facility Type: Other - PRIVATE DUTY AGENCY

Certificate Type: Waiver
NPI Number: 1134821416

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 25D2280573
LAB Type Other - PRIVATE DUTY AGENCY
Facility Name CARE COMPANION AT HOME LLC
Street 225 GENERAL ROBERT E BLOUNT DR
City BASSFIELD
State MS
ZIP 39421
Phone 601 606-0784
CertificateType 4
CertificateEffectiveDate 4/21/2023
CertificateExpirationDate 4/20/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024