Provider Demographics
NPI:1942506043
Name:CIRCLE OF FRIENDS ADULT SERVICES, INC.
Entity Type:Organization
Organization Name:CIRCLE OF FRIENDS ADULT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GIDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-566-5724
Mailing Address - Street 1:3126 ALFRED AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-1912
Mailing Address - Country:US
Mailing Address - Phone:314-776-7888
Mailing Address - Fax:
Practice Address - Street 1:3126 ALFRED AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1912
Practice Address - Country:US
Practice Address - Phone:314-776-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO923261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care