Healthcare Provider Details

I. General information

NPI: 1841347499
Provider Name (Legal Business Name): COMPASS HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 CROSSWINDS COURT
WENTZVILLE MO
63385
US

IV. Provider business mailing address

161 PIEPER ROAD
O'FALLON MO
63366
US

V. Phone/Fax

Practice location:
  • Phone: 636-978-3132
  • Fax:
Mailing address:
  • Phone: 636-978-3132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number032068
License Number StateMO

VIII. Authorized Official

Name: MS. TERESA PORTER
Title or Position: CREDENTIALING/CONTRACTING MANAGER
Credential:
Phone: 660-890-8186