Provider Demographics
NPI:1619837713
Name:COMPLETE FULL CIRCLE INC.
Entity type:Organization
Organization Name:COMPLETE FULL CIRCLE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-554-1355
Mailing Address - Street 1:2551 SONORA SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-5280
Mailing Address - Country:US
Mailing Address - Phone:575-554-1355
Mailing Address - Fax:
Practice Address - Street 1:123 ASPEN DR
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9193
Practice Address - Country:US
Practice Address - Phone:575-554-1355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-12
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health