Healthcare Provider Details

I. General information

NPI: 1467691873
Provider Name (Legal Business Name): CIRCLE OF FRIENDS SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 DELTONA BLVD SUITE A
DELTONA FL
32725-8016
US

IV. Provider business mailing address

517 DELTONA BLVD SUITE A
DELTONA FL
32725-8016
US

V. Phone/Fax

Practice location:
  • Phone: 386-259-5413
  • Fax: 386-753-9265
Mailing address:
  • Phone: 386-259-5413
  • Fax: 386-753-9265

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: MS. BARBARA JEAN DEFAZZIO
Title or Position: PRESIDENT
Credential: LMHC
Phone: 386-259-5413