MEDICARE: COMPASS HOUSE

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	:	1790156826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS HOUSE

Provider Business Mailing Address
First Line	:	1451 MAIN ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14209-1732
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 MAIN ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14209-1732
Country	:	US
Telephone Number	:	716-886-1351
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LISA FREEMAN
Credential	:
Telephone Number	:	716-886-1351

Provider Enumeration Date	:	10/15/2015
Last Update Date	:	10/15/2015

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Directions to “COMPASS HOUSE ” Practice Location

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