Healthcare Provider Details

I. General information

NPI: 1023433927
Provider Name (Legal Business Name): CIRCLES OF CARING ADULT DAY HEALTH FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E PALOUSE RIVER DR
MOSCOW ID
83843-8915
US

IV. Provider business mailing address

225 E PALOUSE RIVER DR
MOSCOW ID
83843-8915
US

V. Phone/Fax

Practice location:
  • Phone: 208-883-6483
  • Fax: 208-883-6489
Mailing address:
  • Phone: 208-883-6483
  • Fax: 208-883-6489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARBARA ANNE MAHONEY
Title or Position: EXECUTIVE DIRECTOR
Credential: OTR/L
Phone: 208-883-6483