1346524113 NPI number — COMPASS HEALTH CARE INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346524113 NPI number — COMPASS HEALTH CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASS HEALTH CARE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMPASS BEHAVIORAL HEALTHCARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346524113
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2475 N JACKRABBIT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85745-1208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-882-5608
Provider Business Mailing Address Fax Number:
520-617-0209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2499 E AJO WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85713-6202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-618-8700
Provider Business Practice Location Address Fax Number:
520-327-9817
Provider Enumeration Date:
09/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SILCOX
Authorized Official First Name:
MARY JO
Authorized Official Middle Name:
K
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
520-882-5608

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  BH-3874 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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