Healthcare Provider Details

I. General information

NPI: 1912853318
Provider Name (Legal Business Name): SUPPORTIVE CIRCLE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 LYMAN ST APT 1
WALTHAM MA
02452-5628
US

IV. Provider business mailing address

136 LYMAN ST APT 1
WALTHAM MA
02452-5628
US

V. Phone/Fax

Practice location:
  • Phone: 617-208-9239
  • Fax:
Mailing address:
  • Phone: 617-208-9239
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINE KIRABO PRAISE
Title or Position: PRESIDENT
Credential: NONE
Phone: 617-208-9239