Provider Demographics
NPI:1679506646
Name:COMPASS HOUSE
Entity Type:Organization
Organization Name:COMPASS HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACEY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:440-246-5111
Mailing Address - Street 1:1440 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3541
Mailing Address - Country:US
Mailing Address - Phone:440-246-5111
Mailing Address - Fax:440-246-5117
Practice Address - Street 1:2926 WOOD AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1624
Practice Address - Country:US
Practice Address - Phone:440-277-7004
Practice Address - Fax:440-277-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2515324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility