Provider Demographics
NPI:1902132673
Name:COMPASS FOR LIFE, LLC
Entity Type:Organization
Organization Name:COMPASS FOR LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-670-1000
Mailing Address - Street 1:P.O. BOX 12607
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561
Mailing Address - Country:US
Mailing Address - Phone:252-636-1648
Mailing Address - Fax:252-636-1834
Practice Address - Street 1:2507A NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-3361
Practice Address - Country:US
Practice Address - Phone:252-636-1648
Practice Address - Fax:252-636-1834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health