NPIMap

Organization Active NPI

Full Circle Home Care, LLC

  • Community/Behavioral Health Agency
  • Crofton, MD
National Provider Identifier
1649983495
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FULL CIRCLE HOME CARE, LLC
Practice address
2131 Espey CT Ste 2
Crofton, MD 21114-2474
Phone
(410) 487-4300
NPI assigned
Dec 26, 2022
Organization subpart
Yes
Parent organization
FULL CIRCLE HOME CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Shanell Nicole JacobsNPI 1275023152
Title
Owner
Phone
(410) 487-4300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Recovery Care Clinic/Center 261QR0800X

Addresses

Primary practice location

2131 Espey CT Ste 2
Crofton, MD 21114-2474

Mailing address

2131 Espey CT Ste 2
Crofton, MD 21114-2474
Phone (410) 487-4300

Other identifiers 1

IdentifierTypeStateIssuer
502586900MedicaidMD

Other names 1

  • Full Circle Youth & Family Center Doing business as

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address info@fullcircleyouthfamilycenter.com Direct
Direct Messaging Address info@fullcircleyouthfamilycenter.com Direct
CONNECT URL fullcircleyouthfamilycenter.com Health Information Exchange (HIE)
Other URL fullcircleyouthfamilycenter.com Other

National Provider Directory

National Provider Directory
Tax ID family
Full Circle Home Care LLC3 organizations share this tax ID, including this one
Part of
Full Circle Home Care LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2131 Espey Ct
Ste 2
Crofton, MD 21114
Phone (410) 487-4300

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1649983495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 ESPEY CT STE 2",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142474",
            "telephone_number": "410-487-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 ESPEY CT STE 2",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142474",
            "telephone_number": "410-487-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CIRCLE HOME CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FULL CIRCLE HOME CARE",
        "enumeration_date": "2022-12-26",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "SHANELL",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-487-4300"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502586900",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@fullcircleyouthfamilycenter.com",
            "affiliation": "N",
            "endpointDescription": "info@fullcircleyouthfamilycenter.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2131 Espey Ct Ste 2",
            "city": "Crofton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211142474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@fullcircleyouthfamilycenter.com",
            "affiliation": "N",
            "endpointDescription": "info@fullcircleyouthfamilycenter.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2131 Espey Ct Ste 2",
            "city": "Crofton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211142474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fullcircleyouthfamilycenter.com",
            "affiliation": "N",
            "endpointDescription": "fullcircleyouthfamilycenter.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2131 Espey Ct Ste 2",
            "city": "Crofton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211142474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fullcircleyouthfamilycenter.com",
            "affiliation": "N",
            "endpointDescription": "fullcircleyouthfamilycenter.com",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "fullcircleyouthfamilycenter.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fullcircleyouthfamilycenter.com",
            "address_1": "2131 Espey Ct Ste 2",
            "city": "Crofton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211142474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Full Circle Youth & Family Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.