Provider Demographics
NPI:1881370062
Name:CONCIERGE CARE LLC
Entity type:Organization
Organization Name:CONCIERGE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON-BULLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-260-5481
Mailing Address - Street 1:8867 BLUE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8724
Mailing Address - Country:US
Mailing Address - Phone:510-260-5481
Mailing Address - Fax:209-259-1490
Practice Address - Street 1:8867 BLUE RIVER DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8724
Practice Address - Country:US
Practice Address - Phone:510-260-5481
Practice Address - Fax:209-259-1490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health