Healthcare Provider Details
I. General information
NPI: 1154907863
Provider Name (Legal Business Name): CONCIERGE HOME HEALTH CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2021
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
196 W ASHLAND ST # 435
DOYLESTOWN PA
18901-4040
US
IV. Provider business mailing address
3 GRACE AVE STE 181
GREAT NECK NY
11021-2400
US
V. Phone/Fax
- Phone: 215-703-8085
- Fax:
- Phone: 516-362-3000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIA
AKINYOOYE
Title or Position: MANAGER
Credential:
Phone: 215-703-8085