MEDICARE: COMPASS HEALTH, 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
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1891040077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS HEALTH, INC.

Provider Business Mailing Address
First Line	:	1800 COMMUNITY
Second Line	:
City	:	CLINTON
State	:	MO
Zip	:	64735-8804
Country	:	US
Telephone Number	:	844-853-8937
Fax Number	:	636-931-1961

Provider Business Practice Location Address
First Line	:	324 EMERSON RD
Second Line	:
City	:	HIGH RIDGE
State	:	MO
Zip	:	63049-2542
Country	:	US
Telephone Number	:	636-677-9977
Fax Number	:	636-677-9179

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	TERESA L PORTER
Credential	:
Telephone Number	:	636-466-6452

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	08/21/2023

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