Provider Demographics
NPI:1851179485
Name:CIRCLE OF LIFE PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:CIRCLE OF LIFE PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-750-6632
Mailing Address - Street 1:901 JONES RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0875
Mailing Address - Country:US
Mailing Address - Phone:479-750-6632
Mailing Address - Fax:
Practice Address - Street 1:901 JONES RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0875
Practice Address - Country:US
Practice Address - Phone:479-750-6632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIRCLE OF LIFE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-15
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty