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General NPI Number Information
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NPI Number | 1124459029
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Entity Type | Organization
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Legal Business Name | COMPASS HOME SERVICES, LLC
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 5500 MAIN ST STE 222
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6737
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Country | US
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Telephone | 716-565-3103
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Fax | 716-565-3107
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Provider Business Mailing Address
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Address Line | 5500 MAIN ST STE 222
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6737
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Country | US
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Telephone | 716-565-3103
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Fax | 716-565-3107
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. WILLIAM PETER GILLICK
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Credential |
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Telephone | 716-565-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1358L001
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License Number State | NY
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