Provider Demographics
NPI:1508474594
Name:CIRCLE OF FRIENDS RAL, INC
Entity Type:Organization
Organization Name:CIRCLE OF FRIENDS RAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:KOLOSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-561-2763
Mailing Address - Street 1:1615 N NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-4358
Mailing Address - Country:US
Mailing Address - Phone:520-274-7575
Mailing Address - Fax:520-844-8426
Practice Address - Street 1:1615 N NORTON AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4358
Practice Address - Country:US
Practice Address - Phone:520-274-7575
Practice Address - Fax:520-844-8426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility