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General NPI Number Information
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NPI Number | 1881002061
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Entity Type | Organization
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Legal Business Name | COMPASS ACADEMY TRANSITIONAL SERVICES LLC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 4800 E 17160 N
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City | MORONI
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State | UT
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Zip | 84646
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Country | US
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Telephone | 435-851-9664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 28
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City | MORONI
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State | UT
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Zip | 84646-0028
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAN SPERRY
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Credential |
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Telephone | 435-864-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | UT
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