Provider Demographics
NPI:1003401423
Name:GERALD COMPASSION LCC
Entity Type:Organization
Organization Name:GERALD COMPASSION LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ALEASE
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-663-0695
Mailing Address - Street 1:300 ADDISON WAY APT 14-1B
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9292
Mailing Address - Country:US
Mailing Address - Phone:806-663-0695
Mailing Address - Fax:804-733-1000
Practice Address - Street 1:300 ADDISON WAY APT 14-1B
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9292
Practice Address - Country:US
Practice Address - Phone:806-663-0695
Practice Address - Fax:804-733-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty