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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891980827
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	:	660-890-8186
Fax Number	:

Provider Business Practice Location Address
First Line	:	851E 5TH STREET,SUITE 132
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-3128
Country	:	US
Telephone Number	:	636-239-8397
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING/CONTRACTING MANAGER
Name	:	TERESA PORTER
Credential	:
Telephone Number	:	660-890-8186

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	03/17/2015

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Directions to “COMPASS HEALTH, INC. ” Practice Location

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