Full Circle Home Care, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FULL CIRCLE HOME CARE, LLC

Doing business as

Full Circle Youth & Family Center

Practice address

2131 Espey CT Ste 2
Crofton, MD 21114-2474

Phone

(410) 487-4300

NPI assigned

Dec 28, 2022

Organization subpart

Yes

Parent organization

FULL CIRCLE HOME CAREAs reported in NPPES

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Full Circle Youth & Family Center Doing business as

Electronic endpoints 1

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.

• Full Circle Home Care, LLC

  • In Home Supportive Care Agency
  • Crofton, MD
  • NPI 1205589082
  NPD tax ID
• Full Circle Home Care, LLC

  dba Full Circle Youth & Family Center

  • Community/Behavioral Health Agency
  • Crofton, MD
  • NPI 1649983495
  NPD tax ID

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.

• Full Circle Home Care, LLC

  • In Home Supportive Care Agency
  • Crofton, MD
  • NPI 1205589082
  NPPES parent name

Practitioners 1

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

• Shanell Jacobs

  • In Home Supportive Care Agency
  • Chesterfield, MO
  • NPI 1275023152
  NPD Authorized official

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1902519697",
    "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": "2022-12-28",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-26",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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": "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"
        }
    ],
    "other_names": [
        {
            "organization_name": "Full Circle Youth & Family Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sofia Marie Fratino, RBT
• Taniya Michelle Freeman
• Franklin F Frush, DDS
• Full Circle Home Care, LLC
• Full Circle Home Care, LLC (Full Circle Youth & Family Center)
• Sunny L Fulton
• Allison Nicole Funk, ATC
• Eric John Gabriel, D.D.S.
• Renita Cherise Gabriel, PSY.D.
• Barbara Galuska, LCSW-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Crofton, MD
• Providers in Crofton, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.