Organization
CIRCLES OF LOVE BIBLE CHURCH
Active
Other names
United Providers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAN GANT MBA (CEO)
(719) 291-0296
Entity
Organization
Contact information
Practice address
6197 LEHMAN DR, COLORADO SPRINGS, CO 80918-3437
(719) 291-0296
Mailing address
PO BOX 1818, COLORADO SPRINGS, CO 80901-1818
(719) 291-0296
(844) 272-3465
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
347C00000X
Private Vehicle
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73704253
—
CO
Enumeration date
05/05/2016
Last updated
08/16/2019
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