Provider Demographics
NPI:1114577459
Name:COMPASS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:COMPASS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMHW
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUMPHUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-698-9128
Mailing Address - Street 1:2920 N KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-6701
Mailing Address - Country:US
Mailing Address - Phone:317-423-9350
Mailing Address - Fax:
Practice Address - Street 1:2920 N KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-6701
Practice Address - Country:US
Practice Address - Phone:317-423-9350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty