Provider Demographics
NPI:1407123177
Name:FULL CIRCLE HOME HEALTH CARE
Entity Type:Organization
Organization Name:FULL CIRCLE HOME HEALTH CARE
Other - Org Name:FULL CIRCLE ASSISTED LIVING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANASIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-320-8030
Mailing Address - Street 1:443 BAGWELL RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-9347
Mailing Address - Country:US
Mailing Address - Phone:678-320-8030
Mailing Address - Fax:
Practice Address - Street 1:443 BAGWELL RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-9347
Practice Address - Country:US
Practice Address - Phone:678-320-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-24
Last Update Date:2011-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care