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General NPI Number Information
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NPI Number | 1437213386
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Entity Type | Organization
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Legal Business Name | COMPASS RECOVERY CENTER
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 109 E MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-3101
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Country | US
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Telephone | 330-298-9391
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Fax |
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Provider Business Mailing Address
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Address Line | 237 OLD OAK DR
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City | CORTLAND
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State | OH
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Zip | 44410-1121
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Country | US
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Telephone | 330-979-7246
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHERYL K. ROTH
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Credential |
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Telephone | 330-298-9391
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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 | E-0001027
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License Number State | OH
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