Healthcare Provider Details

I. General information

NPI: 1992160071
Provider Name (Legal Business Name): CONCIERGE HOME CARE SERVICES OF WEST MICHIGAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2015
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 56TH STREET SW
WYOMING MI
49509
US

IV. Provider business mailing address

1360 56TH STREET SW
WYOMING MI
49509
US

V. Phone/Fax

Practice location:
  • Phone: 616-780-6030
  • Fax:
Mailing address:
  • Phone: 616-780-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARMEN LOUISE TAYLOR-NWACHUKWU
Title or Position: FOUNDER/OWNER
Credential: BSHA, M.S.
Phone: 616-780-6030