Provider Demographics
NPI:1326730409
Name:CIRCLE OF CARE, ST. LOUIS
Entity Type:Organization
Organization Name:CIRCLE OF CARE, ST. LOUIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-873-3501
Mailing Address - Street 1:423 CHEZ PAREE DR
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-3599
Mailing Address - Country:US
Mailing Address - Phone:314-873-3501
Mailing Address - Fax:
Practice Address - Street 1:423 CHEZ PAREE DR
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-3599
Practice Address - Country:US
Practice Address - Phone:314-873-3501
Practice Address - Fax:314-328-5604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization