Provider Demographics
NPI:1225912231
Name:COMPASS COUNSELORS LTD.
Entity type:Organization
Organization Name:COMPASS COUNSELORS LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:FRESHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-261-6129
Mailing Address - Street 1:616 IAA DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-2225
Mailing Address - Country:US
Mailing Address - Phone:309-261-6129
Mailing Address - Fax:
Practice Address - Street 1:616 IAA DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-2225
Practice Address - Country:US
Practice Address - Phone:309-261-6129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)