Provider Demographics
NPI:1033697875
Name:CAREGIVER CONCIERGE SERVICES
Entity Type:Organization
Organization Name:CAREGIVER CONCIERGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:FANTAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-427-8843
Mailing Address - Street 1:PO BOX 1145
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-8145
Mailing Address - Country:US
Mailing Address - Phone:716-427-8843
Mailing Address - Fax:
Practice Address - Street 1:139 WENDE ST LOWR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14211-1728
Practice Address - Country:US
Practice Address - Phone:716-427-8843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty