Provider Demographics
NPI:1962298638
Name:A CIRCLE OF LIFE HOME CARE LLC
Entity type:Organization
Organization Name:A CIRCLE OF LIFE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-979-9501
Mailing Address - Street 1:313 OFFICE SQUARE LN STE 200G
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3657
Mailing Address - Country:US
Mailing Address - Phone:757-979-9501
Mailing Address - Fax:
Practice Address - Street 1:313 OFFICE SQUARE LN STE 200G
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3657
Practice Address - Country:US
Practice Address - Phone:757-979-4202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health