MEDICARE: CARE HOME CONCIERGE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1063161800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE HOME CONCIERGE LLC

Provider Business Mailing Address
First Line	:	22025 VENTURA BLVD STE 205
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-5723
Country	:	US
Telephone Number	:	818-436-2906
Fax Number	:

Provider Business Practice Location Address
First Line	:	22025 VENTURA BLVD STE 205
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-5723
Country	:	US
Telephone Number	:	818-436-2906
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SECRETARY
Name	:	FELIX I IDIGA
Credential	:
Telephone Number	:	661-435-7141

Provider Enumeration Date	:	03/21/2022
Last Update Date	:	03/21/2022

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