Provider Demographics
NPI:1578705794
Name:FULL CIRCLE MINISTRIES
Entity Type:Organization
Organization Name:FULL CIRCLE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:813-964-5511
Mailing Address - Street 1:705 W FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3422
Mailing Address - Country:US
Mailing Address - Phone:813-964-5511
Mailing Address - Fax:813-341-5511
Practice Address - Street 1:705 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3422
Practice Address - Country:US
Practice Address - Phone:813-964-5511
Practice Address - Fax:813-341-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty