Healthcare Provider Details

I. General information

NPI: 1487524880
Provider Name (Legal Business Name): CONCORD HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N WASHINGTON SQ STE 300
LANSING MI
48933-1658
US

IV. Provider business mailing address

120 N WASHINGTON SQ STE 300
LANSING MI
48933-1658
US

V. Phone/Fax

Practice location:
  • Phone: 517-370-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CORWIN COOPER
Title or Position: PRESIDENT
Credential:
Phone: 517-370-2273