Provider Demographics
NPI:1356664874
Name:CIRCLE OF LIFE CORPORATION
Entity Type:Organization
Organization Name:CIRCLE OF LIFE CORPORATION
Other - Org Name:CIRCLE OF LIFE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-835-9188
Mailing Address - Street 1:775 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1861
Mailing Address - Country:US
Mailing Address - Phone:330-835-9188
Mailing Address - Fax:330-835-9108
Practice Address - Street 1:775 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1861
Practice Address - Country:US
Practice Address - Phone:330-835-9188
Practice Address - Fax:330-835-9108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1894473253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care