MEDICARE: CONCIERGE ENTERPRISES HOME CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	310400000X	Assisted Living Facility
2	311Z00000X	Custodial Care Facility
3	3104A0625X	Assisted Living Facility (Mental Illness)
4	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1174477095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCIERGE ENTERPRISES HOME CARE LLC

Provider Business Mailing Address
First Line	:	122 ARBOR CRK
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-8957
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 ACADEMY ST
Second Line	:
City	:	AMERICUS
State	:	GA
Zip	:	31709-3103
Country	:	US
Telephone Number	:	478-444-2044
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANTIRIA JENKINS
Credential	:
Telephone Number	:	478-733-0777

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/27/2026

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