Provider Demographics
NPI:1437513579
Name:CONCIERGE HOME SERVICES, INC
Entity Type:Organization
Organization Name:CONCIERGE HOME SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:904-662-4853
Mailing Address - Street 1:4656 TUNIS ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-7339
Mailing Address - Country:US
Mailing Address - Phone:904-662-4853
Mailing Address - Fax:904-212-0381
Practice Address - Street 1:4656 TUNIS ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-7339
Practice Address - Country:US
Practice Address - Phone:904-662-4853
Practice Address - Fax:904-212-0381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234179253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care