Provider Demographics
NPI:1578269247
Name:OVER THE HORIZON CONCIERGE SERVICES LLC
Entity Type:Organization
Organization Name:OVER THE HORIZON CONCIERGE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARMANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-669-6763
Mailing Address - Street 1:1151 LAKE BLANCHE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-6954
Mailing Address - Country:US
Mailing Address - Phone:407-669-6763
Mailing Address - Fax:
Practice Address - Street 1:1151 LAKE BLANCHE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-6954
Practice Address - Country:US
Practice Address - Phone:407-669-6763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty