Provider Demographics
NPI:1245991264
Name:LIFE COMPASS INTEGRATIVE SERVICES
Entity type:Organization
Organization Name:LIFE COMPASS INTEGRATIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-601-1003
Mailing Address - Street 1:105 E ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4572
Mailing Address - Country:US
Mailing Address - Phone:530-601-1003
Mailing Address - Fax:
Practice Address - Street 1:105 E ST STE 2E
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4572
Practice Address - Country:US
Practice Address - Phone:530-601-1003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty