Basic Information
| Provider Information | |||||||||
| NPI: | 1841538337 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPASS HEALTH SYSTEMS OF NEVADA, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1065 NE 125TH ST | ||||||||
| Address2: | SUITE 409 | ||||||||
| City: | NORTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331615821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058910050 | ||||||||
| FaxNumber: | 3055037363 | ||||||||
| Practice Location | |||||||||
| Address1: | 5900 W ROCHELLE AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891033304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888526672 | ||||||||
| FaxNumber: | 3055037363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2013 | ||||||||
| LastUpdateDate: | 01/21/2013 | ||||||||
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| AuthorizedOfficialLastName: | SEGAL | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO/ PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3058910050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.