Provider Demographics
NPI:1518777077
Name:FULL CIRCLE LIFE COACHING, LLC
Entity type:Organization
Organization Name:FULL CIRCLE LIFE COACHING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:RASHAD
Authorized Official - Last Name:STANCLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-617-8115
Mailing Address - Street 1:1887 MAPLEVIEW ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4960
Mailing Address - Country:US
Mailing Address - Phone:616-617-8115
Mailing Address - Fax:
Practice Address - Street 1:1887 MAPLEVIEW ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4960
Practice Address - Country:US
Practice Address - Phone:616-617-8115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty