Healthcare Provider Details

I. General information

NPI: 1922942903
Provider Name (Legal Business Name): CIRCLE OF CARE HEALTHCARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HERITAGE BLVD STE 206
FORT MILL SC
29715-6447
US

IV. Provider business mailing address

211 HERITAGE BLVD STE 206
FORT MILL SC
29715-6447
US

V. Phone/Fax

Practice location:
  • Phone: 980-202-8055
  • Fax:
Mailing address:
  • Phone: 980-202-8055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY NICOLE CAREY
Title or Position: CEO
Credential:
Phone: 980-202-8055