Provider Demographics
NPI:1164725925
Name:LAWRENCE CARECONCEPT, INC.
Entity Type:Organization
Organization Name:LAWRENCE CARECONCEPT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-651-7488
Mailing Address - Street 1:21205 NW 14TH PL APT 219
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-7445
Mailing Address - Country:US
Mailing Address - Phone:305-651-7488
Mailing Address - Fax:305-651-7488
Practice Address - Street 1:21205 NW 14TH PL APT 219
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-7445
Practice Address - Country:US
Practice Address - Phone:305-651-7488
Practice Address - Fax:305-651-7488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000224200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000224200OtherMED WAVIER PROVIVER