Provider Demographics
NPI:1871125435
Name:CIRCLE OF HOPE, LLC
Entity type:Organization
Organization Name:CIRCLE OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:ARLEEN
Authorized Official - Last Name:MANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHP-R
Authorized Official - Phone:757-334-0773
Mailing Address - Street 1:818 SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4131
Mailing Address - Country:US
Mailing Address - Phone:757-334-0773
Mailing Address - Fax:
Practice Address - Street 1:818 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4131
Practice Address - Country:US
Practice Address - Phone:757-334-0773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)