Provider Demographics
NPI:1568828762
Name:COMPASS COMMUNITY CARE INC.
Entity type:Organization
Organization Name:COMPASS COMMUNITY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GODDEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:EJUWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-725-8732
Mailing Address - Street 1:1706 FURROW LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5649
Mailing Address - Country:US
Mailing Address - Phone:214-725-8732
Mailing Address - Fax:
Practice Address - Street 1:3602 MATLOCK RD STE 210
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3600
Practice Address - Country:US
Practice Address - Phone:214-725-8732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251E00000XAgenciesHome Health