Provider Demographics
NPI:1811918279
Name:COMPASS HEALTH INC
Entity type:Organization
Organization Name:COMPASS HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-474-7010
Mailing Address - Street 1:200 S 13TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-3302
Mailing Address - Country:US
Mailing Address - Phone:805-474-7010
Mailing Address - Fax:805-473-8766
Practice Address - Street 1:1425 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5936
Practice Address - Country:US
Practice Address - Phone:805-543-0210
Practice Address - Fax:805-545-8216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000035314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05079IMedicaid
CA055079Medicare Oscar/Certification