Provider Demographics
NPI:1063223378
Name:CIRCLE OF STRENGTH RECOVERY
Entity type:Organization
Organization Name:CIRCLE OF STRENGTH RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTEKELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-482-1370
Mailing Address - Street 1:2216 WILLETTA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-2842
Mailing Address - Country:US
Mailing Address - Phone:323-509-3009
Mailing Address - Fax:323-927-1504
Practice Address - Street 1:2216 WILLETTA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2842
Practice Address - Country:US
Practice Address - Phone:323-509-3009
Practice Address - Fax:323-927-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility