Provider Demographics
NPI:1669023230
Name:CONCIERGE CAREGIVER SERVICES
Entity Type:Organization
Organization Name:CONCIERGE CAREGIVER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-440-3094
Mailing Address - Street 1:141 KIOWA TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5638
Mailing Address - Country:US
Mailing Address - Phone:615-440-3094
Mailing Address - Fax:615-807-3500
Practice Address - Street 1:141 KIOWA TRL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5638
Practice Address - Country:US
Practice Address - Phone:615-440-3094
Practice Address - Fax:615-807-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN374U00000XMedicaid