Provider Demographics
NPI:1497526453
Name:CIRCLE OF LIFE NURSING AGENCY, LLC
Entity Type:Organization
Organization Name:CIRCLE OF LIFE NURSING AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FLEMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:864-787-3334
Mailing Address - Street 1:27 ECHO VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4469
Mailing Address - Country:US
Mailing Address - Phone:864-787-3334
Mailing Address - Fax:864-787-3334
Practice Address - Street 1:900 W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1455
Practice Address - Country:US
Practice Address - Phone:186-478-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health