Provider Demographics
NPI:1295257681
Name:COMPASSION MENTAL HEALTH SERVICES OF PENNSYLVANIA, PLLC
Entity type:Organization
Organization Name:COMPASSION MENTAL HEALTH SERVICES OF PENNSYLVANIA, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/PSYCHIATRIS
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALMANZAR DISLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-227-4331
Mailing Address - Street 1:3230 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-2936
Mailing Address - Country:US
Mailing Address - Phone:573-825-8145
Mailing Address - Fax:
Practice Address - Street 1:3124 WILMINGTON RD STE 304
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1100
Practice Address - Country:US
Practice Address - Phone:814-227-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4498632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1770926750OtherPSYCHIATRY
PA1770926750OtherPSYCHIATRY