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General NPI Number Information
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NPI Number | 1609150804
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Entity Type | Organization
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Legal Business Name | FAMILY COMPASS
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 10617 GLASS MOUNTAIN TRL
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City | AUSTIN
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State | TX
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Zip | 78750-2502
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Country | US
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Telephone | 512-401-0676
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Fax | 512-401-0676
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Provider Business Mailing Address
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Address Line | PO BOX 500006
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City | AUSTIN
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State | TX
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Zip | 78750-0006
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Country | US
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Telephone | 512-401-0676
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Fax | 512-401-0676
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Authorized Official
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Title or Position | CO-OWNER AND CO-DIRECTOR
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Name | MRS. LETICIA GUTIERREZ
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Credential |
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Telephone | 512-401-0676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 1568248 03
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License Number State | TX
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