Provider Demographics
NPI:1306444120
Name:CIRCLE OF LIFE CAREGIVER SERVICES
Entity type:Organization
Organization Name:CIRCLE OF LIFE CAREGIVER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-566-6237
Mailing Address - Street 1:1803 WYNNTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2929
Mailing Address - Country:US
Mailing Address - Phone:706-566-6237
Mailing Address - Fax:
Practice Address - Street 1:1803 WYNNTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2929
Practice Address - Country:US
Practice Address - Phone:706-566-6237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health