Provider Demographics
NPI:1144793068
Name:CONCISE CARE GROUP
Entity Type:Organization
Organization Name:CONCISE CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO/SEC
Authorized Official - Prefix:
Authorized Official - First Name:CHANNON
Authorized Official - Middle Name:MELLISA
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-529-3269
Mailing Address - Street 1:145 N PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1904
Mailing Address - Country:US
Mailing Address - Phone:323-529-3269
Mailing Address - Fax:323-545-3156
Practice Address - Street 1:145 N PRAIRE AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1904
Practice Address - Country:US
Practice Address - Phone:323-529-3269
Practice Address - Fax:323-545-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty