Organization Name: | COMPASS HEALTH, INC. |
NPI Number: | 1083033591 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERESA PORTER (CREDENTIALING/CONTRACTING MANAGER) |
Mailing Address: | 1032 Crosswinds Ct Wentzville |
State: | MO US |
Postal Code: | 633854836 |
Phone Number: | 6363328318 |
Fax Number: | 6363323045 |
NPI Enumeration Date: | 04/11/2014 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |