Active NPI
Circle of Life Homecare and Consulting Group LLC
- Assisted Living Facility
- Los Angeles, CA
National Provider Identifier
1174382857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- CIRCLE OF LIFE HOMECARE AND CONSULTING GROUP LLC
- Practice address
- 5025 11TH Ave
Los Angeles, CA 90043-4815 - Phone
- (818) 633-6220
- NPI assigned
- Mar 15, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tiffany Charlene Rene Zachery
- Title
- Administrator
- Phone
- (818) 633-6220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
5025 11TH Ave
Los Angeles, CA 90043-4815
Mailing address
5444 Crenshaw Blvd Ste 206
Los Angeles, CA 90043-2408
Phone (818) 633-6220
National Provider Directory
National Provider DirectoryLocations
5444 Crenshaw Blvd
Ste 206
Los Angeles, CA 90043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710460800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710460800000",
"number": "1174382857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5444 CRENSHAW BLVD STE 206",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900432408",
"telephone_number": "818-633-6220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5025 11TH AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900434815",
"telephone_number": "818-633-6220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CIRCLE OF LIFE HOMECARE AND CONSULTING GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-15",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A",
"authorized_official_last_name": "ZACHERY",
"authorized_official_first_name": "TIFFANY",
"authorized_official_middle_name": "CHARLENE RENE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "818-633-6220"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.