Provider Demographics
NPI:1114259397
Name:COMPASS HEALTHCARE
Entity Type:Organization
Organization Name:COMPASS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC; LISAC
Authorized Official - Phone:520-620-6615
Mailing Address - Street 1:1779 W. ST. MARYS RD.
Mailing Address - Street 2:
Mailing Address - City:TUCSPN
Mailing Address - State:AZ
Mailing Address - Zip Code:85745
Mailing Address - Country:US
Mailing Address - Phone:520-620-6615
Mailing Address - Fax:520-622-5045
Practice Address - Street 1:1779 W SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2620
Practice Address - Country:US
Practice Address - Phone:520-620-6615
Practice Address - Fax:520-622-5045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC11296; LISAC1012101Y00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty