Provider Demographics
NPI:1255675385
Name:L. DARLENE COMPTON, LLC
Entity Type:Organization
Organization Name:L. DARLENE COMPTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LISW-S
Authorized Official - Phone:740-644-7948
Mailing Address - Street 1:935 RIVER RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-9584
Mailing Address - Country:US
Mailing Address - Phone:740-644-7948
Mailing Address - Fax:
Practice Address - Street 1:935 RIVER RD
Practice Address - Street 2:SUITE E
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-9584
Practice Address - Country:US
Practice Address - Phone:740-644-7948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0700425261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW37971Medicare PIN