Provider Demographics
NPI:1851757454
Name:CIRCLE OF TRUST HEALING CENTER, LLC
Entity Type:Organization
Organization Name:CIRCLE OF TRUST HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:541-601-6163
Mailing Address - Street 1:3300 BUTLER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9173
Mailing Address - Country:US
Mailing Address - Phone:541-482-2399
Mailing Address - Fax:
Practice Address - Street 1:3300 BUTLER CREEK RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9173
Practice Address - Country:US
Practice Address - Phone:541-482-2399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility