Healthcare Provider Details

I. General information

NPI: 1265677975
Provider Name (Legal Business Name): CIRCLE OF HELP FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E PACIFIC COAST HWY SUITE 105
LONG BEACH CA
90806-5576
US

IV. Provider business mailing address

555 E PACIFIC COAST HWY SUITE 105
LONG BEACH CA
90806-5576
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

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