Provider Demographics
NPI:1245564574
Name:TREATMENT COMPASS
Entity Type:Organization
Organization Name:TREATMENT COMPASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MAEDC, LPC
Authorized Official - Phone:435-459-1043
Mailing Address - Street 1:2615 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-3666
Mailing Address - Country:US
Mailing Address - Phone:435-459-1043
Mailing Address - Fax:
Practice Address - Street 1:2615 CREEKVIEW DR
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-3666
Practice Address - Country:US
Practice Address - Phone:435-459-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health