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NPI Code Detail

MEDICARE: COMPASS BEHAVIORAL CENTER OF ALEXANDRIA, INC.

MEDICARE: COMPASS BEHAVIORAL CENTER OF ALEXANDRIA, INC.
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)194647LA

General Provider Information

NPI Number : 1669463485
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPASS BEHAVIORAL CENTER OF ALEXANDRIA, INC.
Provider Business Mailing Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number : 318-442-9784
Fax Number : 318-442-9785
Provider Business Practice Location Address
First Line : 4606 LEE ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71302-3235
Country : US
Telephone Number : 318-442-9784
Fax Number : 318-442-9785
Authorized Official
Title or Position : CORPORATE COMPLIANCE OFFICER
Name : ANNE DILL
Credential : RN-BC
Telephone Number : 337-788-3330
Provider Enumeration Date : 11/01/2005
Last Update Date : 11/14/2012

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