Healthcare Provider Details

I. General information

NPI: 1679817035
Provider Name (Legal Business Name): CIRCLE OF HOPE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2012
Last Update Date: 11/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 VALERIA ST N
MOBILE AL
36607-2627
US

IV. Provider business mailing address

3100 VALERIA ST N
MOBILE AL
36607-2627
US

V. Phone/Fax

Practice location:
  • Phone: 251-222-0715
  • Fax:
Mailing address:
  • Phone: 251-222-0715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-125505
License Number StateAL

VIII. Authorized Official

Name: MS. LAKESHA LASSITER
Title or Position: OWNER
Credential: RN
Phone: 251-222-2036