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General NPI Number Information
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NPI Number | 1447552625
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Entity Type | Organization
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Legal Business Name | COMMUNITY CIRCLES, INC.
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 240 9TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-1706
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Country | US
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Telephone | 727-742-7250
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Fax | 727-551-0877
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Provider Business Mailing Address
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Address Line | 240 9TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-1706
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Country | US
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Telephone | 727-742-7250
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Fax | 727-551-0877
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BOYD DENNIS SHELT JR.
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Credential |
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Telephone | 727-742-7250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 680178196
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 680178198
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License Number State | FL
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