Provider Demographics
NPI:1689452302
Name:CLASSIQUE CONCIERGE HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CLASSIQUE CONCIERGE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PREETAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEKAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-760-4840
Mailing Address - Street 1:2563 N TOLEDO BLADE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34289-9320
Mailing Address - Country:US
Mailing Address - Phone:937-760-4840
Mailing Address - Fax:
Practice Address - Street 1:2563 N TOLEDO BLADE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34289-9320
Practice Address - Country:US
Practice Address - Phone:937-760-4840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care