Provider Demographics
NPI:1174513394
Name:COMPASS BEHAVIORAL CENTER, LLC
Entity type:Organization
Organization Name:COMPASS BEHAVIORAL CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:337-788-3380
Mailing Address - Street 1:1526 N AVENUE I
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2434
Mailing Address - Country:US
Mailing Address - Phone:337-788-3380
Mailing Address - Fax:337-788-3381
Practice Address - Street 1:1526 N AVENUE I
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2434
Practice Address - Country:US
Practice Address - Phone:337-788-3380
Practice Address - Fax:337-788-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1704351Medicaid
LA586OtherDHH
LA194085Medicare Oscar/Certification