Provider Demographics
NPI:1982372736
Name:IV LEAGUE NURSE CONCIERGE
Entity Type:Organization
Organization Name:IV LEAGUE NURSE CONCIERGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ANGELINA ROSADO
Authorized Official - Last Name:LIGHTFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-860-7195
Mailing Address - Street 1:23206 WOODLAWN RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2262
Mailing Address - Country:US
Mailing Address - Phone:706-617-7459
Mailing Address - Fax:
Practice Address - Street 1:22610 US HIGHWAY 281 N STE 206
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7562
Practice Address - Country:US
Practice Address - Phone:210-860-7195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-04
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)