Provider Demographics
NPI:1902181886
Name:CIRCLE OF ANGELS HOSPICE, INC
Entity Type:Organization
Organization Name:CIRCLE OF ANGELS HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNBAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-882-8401
Mailing Address - Street 1:2817 HIGHWAY 212 SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-3350
Mailing Address - Country:US
Mailing Address - Phone:770-679-1899
Mailing Address - Fax:770-648-6060
Practice Address - Street 1:2817 HIGHWAY 212 SW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-3350
Practice Address - Country:US
Practice Address - Phone:770-679-1899
Practice Address - Fax:770-648-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
GA385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care