Healthcare Provider Details

I. General information

NPI: 1851804801
Provider Name (Legal Business Name): CIRCLE OF STRENGTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 KENYON AVE
SOUTH PLAINFIELD NJ
07080-3728
US

IV. Provider business mailing address

1403 KENYON AVE
SOUTH PLAINFIELD NJ
07080-3728
US

V. Phone/Fax

Practice location:
  • Phone: 908-397-5717
  • Fax:
Mailing address:
  • Phone: 908-397-5717
  • 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 StateNJ

VIII. Authorized Official

Name: ELISE COUNTS
Title or Position: PRESIDENT
Credential:
Phone: 908-397-5717