Provider Demographics
NPI:1811011497
Name:CIRCLE OF HOPE RESIDENTIAL CARE SERVICES INC
Entity Type:Organization
Organization Name:CIRCLE OF HOPE RESIDENTIAL CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:DANIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-360-1040
Mailing Address - Street 1:1810 S OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-6754
Mailing Address - Country:US
Mailing Address - Phone:812-360-1040
Mailing Address - Fax:
Practice Address - Street 1:1810 S OXFORD DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-6754
Practice Address - Country:US
Practice Address - Phone:812-360-1040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health