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General NPI Number Information
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NPI Number | 1184009094
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Entity Type | Organization
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Legal Business Name | COMPASS FAMILY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 21800 HAGGERTY RD SUITE 205
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City | NORTHVILLE
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State | MI
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Zip | 48167-9163
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Country | US
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Telephone | 248-773-4560
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Fax | 248-735-1010
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Provider Business Mailing Address
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Address Line | 21800 HAGGERTY RD SUITE 205
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City | NORTHVILLE
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State | MI
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Zip | 48167-9163
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Country | US
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Telephone | 248-773-4560
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Fax | 248-735-1010
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Authorized Official
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Title or Position | OWNER
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Name | CARL SIMCOX
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Credential |
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Telephone | 248-767-6697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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