Circle of Love Health Foundation Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CIRCLE OF LOVE HEALTH FOUNDATION INC

Practice address

203 West Elm Street
Brockton, MA 02301

Phone

(857) 300-9107

NPI assigned

Oct 28, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marc Guillaume

Title

Ceo

Phone

(857) 300-9107

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1124840509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PROVIDENCE HWY STE 1104",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266815",
            "telephone_number": "857-300-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 WEST ELM STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "857-300-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE OF LOVE HEALTH FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "GUILLAUME",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "857-300-9107"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L. Churchill
• Jamie Chyat, PA-C
• Michael Cianca, OD
• Maria Christina Ciccolo, LCSW
• Miancy Cime
• Jeff Citro, M.A., M.DIV.
• City of Brockton
• City of Brockton Health Department
• CK Wellness PLLC
• Patricia Ann Clabough

• All providers in Brockton, MA
• Preferred Provider Organization in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.