Organization
HEAVENLY CIRCLE LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN VICENTE (C.E.O)
(440) 396-3246
Entity
Organization
Contact information
Practice address
502 BROADWAY, LORAIN, OH 44052-1732
(440) 282-8022
(440) 282-8024
Mailing address
502 BROADWAY, LORAIN, OH 44052-1732
(440) 282-8022
(440) 282-8024
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076229
—
OH
Enumeration date
06/11/2012
Last updated
11/20/2019
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