Provider Demographics
NPI:1891007886
Name:COMPASS ACADEMY
Entity Type:Organization
Organization Name:COMPASS ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1435-262-7195
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:MORONI
Mailing Address - State:UT
Mailing Address - Zip Code:84646-0028
Mailing Address - Country:US
Mailing Address - Phone:435-436-5321
Mailing Address - Fax:435-436-5322
Practice Address - Street 1:4800 E. 17160 N.
Practice Address - Street 2:
Practice Address - City:MORONI
Practice Address - State:UT
Practice Address - Zip Code:84646
Practice Address - Country:US
Practice Address - Phone:435-436-5321
Practice Address - Fax:435-435-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT16876322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children