Healthcare Provider Details

I. General information

NPI: 1093883498
Provider Name (Legal Business Name): COMPASS ADULT CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 RIDGEFIELD BLVD SUITE 190
ASHEVILLE NC
28806-6206
US

IV. Provider business mailing address

PO BOX 19649
CHARLOTTE NC
28219-9649
US

V. Phone/Fax

Practice location:
  • Phone: 828-350-8506
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEREK BULLARD
Title or Position: CEO
Credential:
Phone: 704-521-4977