Healthcare Provider Details

I. General information

NPI: 1144654054
Provider Name (Legal Business Name): CIRCLE OF HELP FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 CATTARAUGUS AVE ROOM A, PRINCIPAL'S OFFICE
LOS ANGELES CA
90034-1906
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:

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