Provider Demographics
NPI:1811371065
Name:CONCERNED COMPANION CARE
Entity Type:Organization
Organization Name:CONCERNED COMPANION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-242-1130
Mailing Address - Street 1:5971 SUITE C NEW JESUP HWY
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-9518
Mailing Address - Country:US
Mailing Address - Phone:912-324-0696
Mailing Address - Fax:
Practice Address - Street 1:5971 SUITE C NEW JESUP HWY
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-9518
Practice Address - Country:US
Practice Address - Phone:912-324-8177
Practice Address - Fax:912-342-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063-R-1722251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health