Provider Demographics
NPI:1548588098
Name:ASCENT HOMECARE CONCIERGE LLC
Entity Type:Organization
Organization Name:ASCENT HOMECARE CONCIERGE LLC
Other - Org Name:JMP HEALTHCARE SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANYI
Authorized Official - Last Name:NKEMATABONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-226-9996
Mailing Address - Street 1:7217 LOCKPORT PL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1584
Mailing Address - Country:US
Mailing Address - Phone:703-372-2022
Mailing Address - Fax:703-286-7294
Practice Address - Street 1:7217 LOCKPORT PL
Practice Address - Street 2:SUITE 106
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1584
Practice Address - Country:US
Practice Address - Phone:703-226-9996
Practice Address - Fax:703-286-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-07
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO10652251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health