Provider Demographics
NPI:1134400633
Name:COMPASS HEALTH INC
Entity type:Organization
Organization Name:COMPASS HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-474-7010
Mailing Address - Street 1:200 S 13TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-3302
Mailing Address - Country:US
Mailing Address - Phone:805-474-7010
Mailing Address - Fax:805-473-8766
Practice Address - Street 1:3880 VIA LUCERO
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1605
Practice Address - Country:US
Practice Address - Phone:805-687-6651
Practice Address - Fax:805-682-5208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-29
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000007314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050000007Medicaid
CA050000007Medicaid