Provider Demographics
NPI:1225738008
Name:MM FAMILY CIRCLE INCORPORATED
Entity Type:Organization
Organization Name:MM FAMILY CIRCLE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MANNELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-975-2520
Mailing Address - Street 1:3269 SUFFOLK DOWNS
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224
Mailing Address - Country:US
Mailing Address - Phone:614-975-2520
Mailing Address - Fax:
Practice Address - Street 1:581 BOSTON MILLS RD STE 400
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1193
Practice Address - Country:US
Practice Address - Phone:614-975-2520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty