Provider Demographics
NPI:1861014706
Name:COMPASS CARES-NORTH CENTRAL HEALTH DISTRICT
Entity Type:Organization
Organization Name:COMPASS CARES-NORTH CENTRAL HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WRIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:314-779-8466
Mailing Address - Street 1:180 EMERY HWY
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3656
Mailing Address - Country:US
Mailing Address - Phone:478-464-0612
Mailing Address - Fax:478-464-0612
Practice Address - Street 1:180 EMERY HWY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3656
Practice Address - Country:US
Practice Address - Phone:478-464-0612
Practice Address - Fax:478-464-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local