Provider Demographics
NPI:1760945745
Name:COMMUNITY CIRCLES, LLC
Entity Type:Organization
Organization Name:COMMUNITY CIRCLES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETSOULIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-727-7353
Mailing Address - Street 1:104 W SUPERIOR ST # 200
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-3000
Mailing Address - Country:US
Mailing Address - Phone:218-727-7353
Mailing Address - Fax:218-727-2646
Practice Address - Street 1:104 W SUPERIOR ST # 200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-3000
Practice Address - Country:US
Practice Address - Phone:218-727-7353
Practice Address - Fax:218-727-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health