Healthcare Provider Details

I. General information

NPI: 1497921936
Provider Name (Legal Business Name): COMPASS HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 BISHOP ST
SAN LUIS OBISPO CA
93401-4633
US

IV. Provider business mailing address

200 S 13TH ST SUITE 205
GROVER BEACH CA
93433-2263
US

V. Phone/Fax

Practice location:
  • Phone: 805-545-7575
  • Fax: 805-545-7564
Mailing address:
  • Phone: 805-474-7010
  • Fax: 805-473-8766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number050000548
License Number StateCA

VIII. Authorized Official

Name: MS. MARIE MOYA
Title or Position: CONTROLLER
Credential:
Phone: 805-474-7010