Provider Demographics
NPI:1770017865
Name:FULL CIRCLE TO COMPLETION LLC
Entity Type:Organization
Organization Name:FULL CIRCLE TO COMPLETION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARMON
Authorized Official - Suffix:
Authorized Official - Credentials:CDC
Authorized Official - Phone:419-491-1180
Mailing Address - Street 1:316 N. MICHIGAN STREET
Mailing Address - Street 2:SUITE 914
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604
Mailing Address - Country:US
Mailing Address - Phone:419-246-9405
Mailing Address - Fax:419-246-9798
Practice Address - Street 1:316 N. MICHIGAN STREET
Practice Address - Street 2:SUITE 914
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604
Practice Address - Country:US
Practice Address - Phone:419-246-9405
Practice Address - Fax:419-246-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077345Medicaid