Provider Demographics
NPI:1619642972
Name:COMPASSION SERVICES
Entity Type:Organization
Organization Name:COMPASSION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-456-4591
Mailing Address - Street 1:484 TOLLAGE CRK
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-3305
Mailing Address - Country:US
Mailing Address - Phone:606-230-2255
Mailing Address - Fax:606-437-3001
Practice Address - Street 1:484 TOLLAGE CRK
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3305
Practice Address - Country:US
Practice Address - Phone:606-230-2255
Practice Address - Fax:606-437-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100811280Medicaid