Provider Demographics
NPI:1043567811
Name:COMPASS
Entity Type:Organization
Organization Name:COMPASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURDETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-815-3873
Mailing Address - Street 1:180 S MERCER AVE
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-1211
Mailing Address - Country:US
Mailing Address - Phone:724-815-3873
Mailing Address - Fax:
Practice Address - Street 1:10 SNYDER RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3432
Practice Address - Country:US
Practice Address - Phone:724-815-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004876251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health