Healthcare Provider Details

I. General information

NPI: 1801425368
Provider Name (Legal Business Name): CIRCLE OF LIFE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 MOUNTAIN VIEW DR
LAS VEGAS NV
89146-1422
US

IV. Provider business mailing address

6334 CAMINO DEL LAGO
RANCHO MURIETA CA
95683-9245
US

V. Phone/Fax

Practice location:
  • Phone: 619-289-6495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MR. OLIVER OANIA
Title or Position: PRESIDENT
Credential:
Phone: 619-289-6495