Provider Demographics
NPI:1437826039
Name:COMPASSION BEHAVIORAL HEALTH INC
Entity type:Organization
Organization Name:COMPASSION BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLINS
Authorized Official - Middle Name:
Authorized Official - Last Name:IYAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:817-420-2968
Mailing Address - Street 1:2955 BANDERA
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-5553
Mailing Address - Country:US
Mailing Address - Phone:817-420-2968
Mailing Address - Fax:682-282-3115
Practice Address - Street 1:423 W WHEATLAND RD STE 101
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4630
Practice Address - Country:US
Practice Address - Phone:817-420-2858
Practice Address - Fax:682-282-3115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASSION BEHAVIORAL HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-23
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty