Provider Demographics
NPI:1225895758
Name:COMPASS HORIZON LLC
Entity Type:Organization
Organization Name:COMPASS HORIZON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:STOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-409-7718
Mailing Address - Street 1:5020 SPRINGS DR LOT 53
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-4062
Mailing Address - Country:US
Mailing Address - Phone:307-409-7718
Mailing Address - Fax:
Practice Address - Street 1:5020 SPRINGS DR LOT 53
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4062
Practice Address - Country:US
Practice Address - Phone:307-409-7718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty