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Organization

CIRCLE OF LIFE INTERNATIONAL, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SHEAN MAURICE LEWIS (PRESIDENT)
(704) 299-8912
Entity
Organization

Contact information

Practice address
14533 WESTGREEN DR, HUNTERSVILLE, NC 28078-0611
(704) 299-8912
(704) 948-6033
Mailing address
14533 WESTGREEN DR, HUNTERSVILLE, NC 28078-0611
(704) 299-8912
(704) 948-6033

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10422038
VOCATIONAL REHABILITATION SERVICES
NC
Enumeration date
10/13/2008
Last updated
11/10/2009
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