Provider Demographics
NPI:1295208015
Name:CIRCLE OF CARE HOMECARE RESOURCES, LLC
Entity Type:Organization
Organization Name:CIRCLE OF CARE HOMECARE RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-747-5019
Mailing Address - Street 1:17772 IRVINE BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17772 IRVINE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3234
Practice Address - Country:US
Practice Address - Phone:949-388-0018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty