MEDICARE: CIRCLE OF CARE HEALTHCARE AGENCY

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	:	1922942903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLE OF CARE HEALTHCARE AGENCY

Provider Business Mailing Address
First Line	:	211 HERITAGE BLVD STE 206
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-6447
Country	:	US
Telephone Number	:	980-202-8055
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 HERITAGE BLVD STE 206
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-6447
Country	:	US
Telephone Number	:	980-202-8055
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TIFFANY NICOLE CAREY
Credential	:
Telephone Number	:	980-202-8055

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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