MEDICARE: INNER-CIRCLE COMMUNITIES

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1477863165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER-CIRCLE COMMUNITIES

Provider Business Mailing Address
First Line	:	1803 BOSTWICK RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-3368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1803 BOSTWICK RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-3368
Country	:	US
Telephone Number	:	614-517-6272
Fax Number	:

Authorized Official
Title or Position	:	EXECTIVE DIRECTOR/CEO
Name	:	MR. ANTONIO L TRAVIS
Credential	:
Telephone Number	:	614-517-6272

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	10/14/2010

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Directions to “INNER-CIRCLE COMMUNITIES ” Practice Location

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