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NPI Code Detail

MEDICARE: COMPASS POINTE COUNSELING INC

MEDICARE: COMPASS POINTE COUNSELING INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/Center0554225GA

General Provider Information

NPI Number : 1083742456
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPASS POINTE COUNSELING INC
Provider Business Mailing Address
First Line : PO BOX 2017
Second Line :
City : MABELTON
State : GA
Zip : 30126-1016
Country : US
Telephone Number : 678-921-3052
Fax Number :
Provider Business Practice Location Address
First Line : 3188 ATLANTA ROAD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-8256
Country : US
Telephone Number : 678-921-3052
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. KENDRICK ALLEN
Credential :
Telephone Number : 678-521-3092
Provider Enumeration Date : 02/28/2007
Last Update Date : 08/22/2020

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