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NPI 1831591809

NPI 1831591809 : COMPASS COMMUNITY SERVICES : COEUR D ALENE, ID

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General NPI Number Information
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    NPI Number           |    1831591809
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    Entity Type          |    Organization 
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    Legal Business Name  |    COMPASS COMMUNITY SERVICES 
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Dates
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    Enumeration Date     |    09/22/2014
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    Last Update Date     |    09/22/2014
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Provider Practice Location Address
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    Address Line         |    1103 E SHERMAN AVE 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83814-4154
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    Country              |    US
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    Telephone            |    208-660-1709
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1103 E SHERMAN AVE 
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    City                 |    COEUR D ALENE
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    State                |    ID
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    Zip                  |    83814-4154
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    Country              |    US
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    Telephone            |    208-660-1709
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR OF OPERATIONS
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    Name                 |     CASSANDRA  COLEMAN-HEPPLER 
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    Credential           |    LCSW
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    Telephone            |    509-990-6560
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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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