Organization
COMPASS HEALTH, INC.
Active
Other names
Family Dental Center Columbia East
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA L PORTER (CREDENTIALING MANAGER)
(660) 890-8156
Entity
Organization
Contact information
Practice address
2475 BROADWAY BLUFFS DR, SUITE 200, COLUMBIA, MO 65201-8138
(573) 777-9282
(573) 777-9569
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073978664
—
MO
Enumeration date
12/23/2015
Last updated
09/15/2020
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