Provider Demographics
NPI:1932852860
Name:COMPASSIONATE QUALITY PSYCHIATRY LLC
Entity Type:Organization
Organization Name:COMPASSIONATE QUALITY PSYCHIATRY LLC
Other - Org Name:CQTPSYCHIATRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:JOANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUNTACH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:218-969-1347
Mailing Address - Street 1:4135 RICHAR AVENUE SUITE 201
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-8009
Mailing Address - Country:US
Mailing Address - Phone:218-969-1347
Mailing Address - Fax:
Practice Address - Street 1:4135 RICHARD AVE STE 201
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-2979
Practice Address - Country:US
Practice Address - Phone:612-429-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health