Healthcare Provider Details

I. General information

NPI: 1669877817
Provider Name (Legal Business Name): CIRCLE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 EUCLID AVE
CLEVELAND OH
44106-4310
US

IV. Provider business mailing address

12201 EUCLID AVE
CLEVELAND OH
44106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 216-721-4010
  • Fax:
Mailing address:
  • Phone: 216-707-3408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES TONG
Title or Position: CFO
Credential:
Phone: 216-767-3408