Provider Demographics
NPI:1952140253
Name:CONCIERGE COMPASSIONATE CARE LLC
Entity type:Organization
Organization Name:CONCIERGE COMPASSIONATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-240-0957
Mailing Address - Street 1:1801 SWAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-2451
Mailing Address - Country:US
Mailing Address - Phone:903-240-0957
Mailing Address - Fax:
Practice Address - Street 1:1801 SWAN ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2451
Practice Address - Country:US
Practice Address - Phone:903-240-0957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty