Provider Demographics
NPI:1639745474
Name:CIRCLE OF FRIENDS, LLC
Entity Type:Organization
Organization Name:CIRCLE OF FRIENDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TEDDI
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-948-6903
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-0044
Mailing Address - Country:US
Mailing Address - Phone:304-948-6903
Mailing Address - Fax:
Practice Address - Street 1:2 PLATINUM DR
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-9760
Practice Address - Country:US
Practice Address - Phone:304-948-6903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty