Provider Demographics
NPI: | 1851627558 |
---|---|
Name: | COMPASS FOR LIFE, LLC |
Entity Type: | Organization |
Organization Name: | COMPASS FOR LIFE, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERESA |
Authorized Official - Middle Name: | Y |
Authorized Official - Last Name: | SIMPSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 252-670-1000 |
Mailing Address - Street 1: | P.O. BOX 12607 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW BERN |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28561-2607 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 252-636-1648 |
Mailing Address - Fax: | 252-636-1834 |
Practice Address - Street 1: | 2507 A NEUSE BLVD |
Practice Address - Street 2: | |
Practice Address - City: | NEW BERN |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28562-3361 |
Practice Address - Country: | US |
Practice Address - Phone: | 252-636-1648 |
Practice Address - Fax: | 252-636-1834 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-10-30 |
Last Update Date: | 2009-10-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | HC 3854 | 376K00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Single Specialty |