Healthcare Provider Details

I. General information

NPI: 1366876435
Provider Name (Legal Business Name): CIRCLE OF HELP FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 08/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 N WILTON PL #331, #341
HOLLYWOOD CA
90028-8526
US

IV. Provider business mailing address

1011 GOODRICH BLVD
COMMERCE CA
90022-5102
US

V. Phone/Fax

Practice location:
  • Phone: 323-888-9191
  • Fax:
Mailing address:
  • Phone: 323-888-9191
  • Fax: 323-888-9222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELLEN SHAPIRO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 323-888-9191