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General NPI Number Information
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NPI Number | 1932461571
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Entity Type | Organization
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Legal Business Name | HEAVENLY CIRCLE LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 502 BROADWAY
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City | LORAIN
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State | OH
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Zip | 44052-1732
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Country | US
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Telephone | 440-282-8022
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Fax | 440-282-8024
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Provider Business Mailing Address
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Address Line | 502 BROADWAY
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City | LORAIN
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State | OH
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Zip | 44052-1732
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Country | US
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Telephone | 440-282-8022
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Fax | 440-282-8024
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Authorized Official
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Title or Position | C.E.O
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Name | MRS. MARILYN VICENTE
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Credential |
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Telephone | 440-396-3246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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