Provider Demographics
NPI:1407469208
Name:COMPLIMENT LLC
Entity Type:Organization
Organization Name:COMPLIMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:ROA
Authorized Official - Suffix:
Authorized Official - Credentials:CHES
Authorized Official - Phone:469-296-7757
Mailing Address - Street 1:8808 CALISTOGA SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3776
Mailing Address - Country:US
Mailing Address - Phone:469-296-7757
Mailing Address - Fax:972-627-4227
Practice Address - Street 1:8808 CALISTOGA SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3776
Practice Address - Country:US
Practice Address - Phone:469-296-7757
Practice Address - Fax:972-627-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1060814OtherCDC NATIONAL DIABETES PREVENTION PROGRAM