Provider Demographics
NPI:1245945690
Name:COMPASSION BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:COMPASSION BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PURITY
Authorized Official - Middle Name:JEBET
Authorized Official - Last Name:SANG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:515-779-8777
Mailing Address - Street 1:16982 W RIO VISTA LN # A
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-7409
Mailing Address - Country:US
Mailing Address - Phone:515-779-8777
Mailing Address - Fax:
Practice Address - Street 1:16982 W RIO VISTA LN # A
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-7409
Practice Address - Country:US
Practice Address - Phone:515-779-8777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health