Organization Active NPI

Circle of Life Homecare and Consulting Group LLC

  • Assisted Living Facility
  • Los Angeles, CA
National Provider Identifier
1174382857
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
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

Updated by the provider on Mar 15, 2024

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.