Provider Demographics
NPI:1972593697
Name:CIRCLE HOME, INC.
Entity type:Organization
Organization Name:CIRCLE HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRAHER-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSN MBA RN
Authorized Official - Phone:978-805-2651
Mailing Address - Street 1:847 ROGERS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-4345
Mailing Address - Country:US
Mailing Address - Phone:978-805-2651
Mailing Address - Fax:978-441-0007
Practice Address - Street 1:847 ROGERS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-4345
Practice Address - Country:US
Practice Address - Phone:978-805-2651
Practice Address - Fax:978-441-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7217251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110024158BMedicaid
MA221516Medicare Oscar/Certification