Provider Demographics
NPI:1922067693
Name:CIRCLE OF LIFE HOSPICE, INC
Entity Type:Organization
Organization Name:CIRCLE OF LIFE HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO FOUNDER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GIRARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:775-827-2298
Mailing Address - Street 1:1575 DELUCCHI LANE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6578
Mailing Address - Country:US
Mailing Address - Phone:775-827-2298
Mailing Address - Fax:775-824-3860
Practice Address - Street 1:1575 DELUCCHI LANE
Practice Address - Street 2:SUITE 214
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6578
Practice Address - Country:US
Practice Address - Phone:775-827-2298
Practice Address - Fax:775-824-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2911HPC-6251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV006416111Medicaid
NV006516111Medicaid
NV006516111Medicaid
NV006416111Medicaid