Healthcare Provider Details

I. General information

NPI: 1598781189
Provider Name (Legal Business Name): COMPASS HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/04/2023
Certification Date: 07/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E MAIN ST
FESTUS MO
63028-1952
US

IV. Provider business mailing address

227 E MAIN ST
FESTUS MO
63028-1952
US

V. Phone/Fax

Practice location:
  • Phone: 636-931-2700
  • Fax: 636-931-2139
Mailing address:
  • Phone: 636-931-2700
  • Fax: 636-931-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TERESA L PORTER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 660-890-8156