Provider Demographics
NPI:1912072331
Name:COMPASS OF CAROLINA
Entity Type:Organization
Organization Name:COMPASS OF CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTAKE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-467-3434
Mailing Address - Street 1:1100 RUTHERFORD RD
Mailing Address - Street 2:STONE COMMONS
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3927
Mailing Address - Country:US
Mailing Address - Phone:864-467-3434
Mailing Address - Fax:864-467-3571
Practice Address - Street 1:1100 RUTHERFORD RD
Practice Address - Street 2:STONE COMMONS
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3927
Practice Address - Country:US
Practice Address - Phone:864-467-3434
Practice Address - Fax:864-467-3571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health