Organization
FULL CIRCLE HOMECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVANZO LAMANAS TATE (PRESIDENT)
(330) 974-5415
Entity
Organization
Contact information
Practice address
4495 MARKET ST STE 200, BOARDMAN, OH 44512
(330) 974-5415
(234) 719-1476
Mailing address
4495 MARKET ST STE 200, BOARDMAN, OH 44512-1573
(330) 974-5415
(234) 719-1476
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135706
—
OH
Enumeration date
10/21/2015
Last updated
02/19/2019
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