Healthcare Provider Details

I. General information

NPI: 1215345954
Provider Name (Legal Business Name): CIRCLES OF CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 S BABCOCK ST
MELBOURNE FL
32901-5305
US

IV. Provider business mailing address

400 SHERIDAN RD
MELBOURNE FL
32901-3122
US

V. Phone/Fax

Practice location:
  • Phone: 321-676-1260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: JAMES B WHITAKER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 321-722-5200