Provider Demographics
NPI:1053895003
Name:CIRCLE OF LOVE ADULT DAY CENTER
Entity type:Organization
Organization Name:CIRCLE OF LOVE ADULT DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:SOMBOUN
Authorized Official - Last Name:YIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-454-7979
Mailing Address - Street 1:7116 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:BLDG 4
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7116 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:BLDG 4
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071
Practice Address - Country:US
Practice Address - Phone:470-289-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIRCLE OF LOVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care