Healthcare Provider Details

I. General information

NPI: 1588804256
Provider Name (Legal Business Name): CONCIERGE HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W SAN CARLOS ST SUITE 1680
SAN JOSE CA
95110-2726
US

IV. Provider business mailing address

333 W SAN CARLOS ST SUITE 1680
SAN JOSE CA
95110-2726
US

V. Phone/Fax

Practice location:
  • Phone: 408-287-5007
  • Fax: 408-287-3505
Mailing address:
  • Phone: 408-287-5007
  • Fax: 408-287-3505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2817933989
License Number StateCA

VIII. Authorized Official

Name: GREGORY ARECHIGA
Title or Position: CEO/PRESIDENT
Credential:
Phone: 510-299-1080