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General NPI Number Information
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NPI Number | 1366861643
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Entity Type | Organization
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Legal Business Name | COMPASS BEHAVIORAL HEALTH, A FAMILY THERAPY CORP
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 130 S B ST
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City | TUSTIN
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State | CA
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Zip | 92780-3609
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Country | US
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Telephone | 888-265-9114
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Fax | 714-486-1629
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Provider Business Mailing Address
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Address Line | 130 S B ST
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City | TUSTIN
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State | CA
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Zip | 92780-3609
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Country | US
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Telephone | 888-265-9114
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Fax | 714-486-1629
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Authorized Official
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Title or Position | OWNER
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Name | CHERIE LYNN MILLS
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Credential | MFT
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Telephone | 888-265-9114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 40443
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License Number State | CA
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