MEDICARE: COMPASS CARE ALLIANCE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1043530009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS CARE ALLIANCE, LLC

Provider Business Mailing Address
First Line	:	1716 CLEVELAND HWY
Second Line	:	SUITE 500
City	:	DALTON
State	:	GA
Zip	:	30721-2314
Country	:	US
Telephone Number	:	706-272-3040
Fax Number	:	706-272-3000

Provider Business Practice Location Address
First Line	:	1716 CLEVELAND HWY
Second Line	:	SUITE 500
City	:	DALTON
State	:	GA
Zip	:	30721-2314
Country	:	US
Telephone Number	:	706-272-3040
Fax Number	:	706-272-3000

Authorized Official
Title or Position	:	EXAMING PSYCHOLOGIST/OWNER
Name	:	DR. ELIZABETH LADD
Credential	:	PH.D.
Telephone Number	:	706-272-3040

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	06/01/2010

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