Healthcare Provider Details

I. General information

NPI: 1811011497
Provider Name (Legal Business Name): CIRCLE OF HOPE RESIDENTIAL CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 S OXFORD DR
BLOOMINGTON IN
47401-6754
US

IV. Provider business mailing address

1810 S OXFORD DR
BLOOMINGTON IN
47401-6754
US

V. Phone/Fax

Practice location:
  • Phone: 812-360-1040
  • Fax:
Mailing address:
  • Phone: 812-360-1040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER IRENE DANIELSEN
Title or Position: CEO
Credential:
Phone: 812-360-1040