Provider Demographics
NPI:1962088070
Name:MOUNTAIN CIRCLE FAMILY SERVICES, INC
Entity type:Organization
Organization Name:MOUNTAIN CIRCLE FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-895-1110
Mailing Address - Street 1:2550 FLORAL AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9143
Mailing Address - Country:US
Mailing Address - Phone:530-895-1110
Mailing Address - Fax:530-895-0310
Practice Address - Street 1:4600 KIETZKE LN STE H182
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-5042
Practice Address - Country:US
Practice Address - Phone:775-825-9995
Practice Address - Fax:775-825-9877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency