MEDICARE: COMPASS HEALTH, 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
1	101YM0800X	Mental Health Counselor		MO
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598781189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASS HEALTH, INC

Provider Business Mailing Address
First Line	:	227 E MAIN ST
Second Line	:
City	:	FESTUS
State	:	MO
Zip	:	63028-1952
Country	:	US
Telephone Number	:	636-931-2700
Fax Number	:	636-931-2139

Provider Business Practice Location Address
First Line	:	227 E MAIN ST
Second Line	:
City	:	FESTUS
State	:	MO
Zip	:	63028-1952
Country	:	US
Telephone Number	:	636-931-2700
Fax Number	:	636-931-2139

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	TERESA L PORTER
Credential	:
Telephone Number	:	660-890-8156

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	07/04/2023

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Directions to “COMPASS HEALTH, INC ” Practice Location

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