Provider Demographics
NPI:1801617634
Name:BLACK LUXE CONCIERGE LLC
Entity type:Organization
Organization Name:BLACK LUXE CONCIERGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SLADE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:347-843-9318
Mailing Address - Street 1:5409 AVENUE H APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-1604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5409 AVENUE H APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1604
Practice Address - Country:US
Practice Address - Phone:347-843-9318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)