Healthcare Provider Details

I. General information

NPI: 1447481064
Provider Name (Legal Business Name): CONCERNED HOME CARE OUTSOURCING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 N 1ST ST
HARBOR BEACH MI
48441-1102
US

IV. Provider business mailing address

129 N 1ST ST
HARBOR BEACH MI
48441-1102
US

V. Phone/Fax

Practice location:
  • Phone: 989-479-3101
  • Fax:
Mailing address:
  • Phone: 989-479-3101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. EMELIN JOY TAN
Title or Position: MANAGING MEMBER
Credential: RN, BSN
Phone: 989-479-3101