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General NPI Number Information
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NPI Number | 1841783289
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Entity Type | Organization
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Legal Business Name | CIRCLE OF LIFE THERAPY SERVICES LLC
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 1001 W JEFFERSON ST
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City | CRESTON
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State | IA
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Zip | 50801-3008
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Country | US
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Telephone | 641-344-8567
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 W JEFFERSON ST
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City | CRESTON
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State | IA
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Zip | 50801-3008
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Country | US
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Telephone | 641-344-8567
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | KAREN JEAN LEONARD
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Credential | BACHELORS IN PSYCH
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Telephone | 641-344-8567
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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 |
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License Number State |
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