MEDICARE: CIRCLE OF LIFE HOME HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1194605998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLE OF LIFE HOME HEALTH

Provider Business Mailing Address
First Line	:	8524 S WESTERN AVE STE 109
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9247
Country	:	US
Telephone Number	:	405-915-7243
Fax Number	:

Provider Business Practice Location Address
First Line	:	8524 S WESTERN AVE STE 109
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9247
Country	:	US
Telephone Number	:	405-915-7243
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RUSSELL E OVERLEY
Credential	:	ADMIN
Telephone Number	:	405-915-7245

Provider Enumeration Date	:	09/03/2025
Last Update Date	:	09/03/2025

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Directions to “CIRCLE OF LIFE HOME HEALTH ” Practice Location

Language	Start Address	Practice Location

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