Provider Demographics
NPI:1194965434
Name:FULL CIRCLE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FULL CIRCLE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:
Authorized Official - Last Name:OXFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-624-1005
Mailing Address - Street 1:1460 MORRIS AVE
Mailing Address - Street 2:SUITE 2(A) & 2(B)
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3337
Mailing Address - Country:US
Mailing Address - Phone:908-624-1005
Mailing Address - Fax:908-624-1010
Practice Address - Street 1:1460 MORRIS AVE
Practice Address - Street 2:SUITE 2(A) & 2(B)
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3337
Practice Address - Country:US
Practice Address - Phone:908-624-1005
Practice Address - Fax:908-624-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHPO122400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health