Provider Demographics
NPI:1932712031
Name:MY COMPANION & CONCIERGE SERVICES
Entity Type:Organization
Organization Name:MY COMPANION & CONCIERGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-873-9198
Mailing Address - Street 1:2400 HERODIAN WAY SE STE 220
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8500
Mailing Address - Country:US
Mailing Address - Phone:678-562-1600
Mailing Address - Fax:
Practice Address - Street 1:2400 HERODIAN WAY SE STE 220
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-8500
Practice Address - Country:US
Practice Address - Phone:678-562-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care