Healthcare Provider Details
I. General information
NPI: 1386773463
Provider Name (Legal Business Name): COMPASS HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2007
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
- Phone: 636-931-2700
- Fax: 636-931-2139
- Phone: 636-931-2700
- Fax: 636-931-2139
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TERESA
L
PORTER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 660-890-8156