Healthcare Provider Details

I. General information

NPI: 1316471170
Provider Name (Legal Business Name): CIRCLE UP HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8336 CENTENARY DR
CAMBY IN
46113-8009
US

IV. Provider business mailing address

8255 CAMBY RD 144
CAMBY IN
46113-2820
US

V. Phone/Fax

Practice location:
  • Phone: 317-850-7092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KEYANA WARREN
Title or Position: CEO
Credential:
Phone: 317-850-7092