Provider Demographics
NPI:1376180273
Name:COMPASS ROSE ACADEMY
Entity Type:Organization
Organization Name:COMPASS ROSE ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-563-1158
Mailing Address - Street 1:5233 S 50 E
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-8011
Mailing Address - Country:US
Mailing Address - Phone:260-569-4757
Mailing Address - Fax:260-563-0318
Practice Address - Street 1:5233 S 50 E
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-8011
Practice Address - Country:US
Practice Address - Phone:260-569-4757
Practice Address - Fax:260-563-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children