Provider Demographics
NPI:1043605215
Name:CIRCLE OF LOVE HOME HEALTH
Entity Type:Organization
Organization Name:CIRCLE OF LOVE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-438-6469
Mailing Address - Street 1:3189 KIRBY WHITTEN RD
Mailing Address - Street 2:203D
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2854
Mailing Address - Country:US
Mailing Address - Phone:901-266-1556
Mailing Address - Fax:901-266-1557
Practice Address - Street 1:3189 KIRBY WHITTEN RD
Practice Address - Street 2:203D
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2854
Practice Address - Country:US
Practice Address - Phone:901-266-1556
Practice Address - Fax:901-266-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000015941251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care