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General NPI Number Information
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NPI Number | 1144793068
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Entity Type | Organization
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Legal Business Name | CONCISE CARE GROUP
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/05/2019
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Provider Practice Location Address
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Address Line | 145 N PRAIRE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-1904
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Country | US
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Telephone | 323-529-3269
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Fax | 323-545-3156
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Provider Business Mailing Address
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Address Line | 145 N PRAIRIE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-1904
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Country | US
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Telephone | 323-529-3269
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Fax | 323-545-3156
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Authorized Official
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Title or Position | CEO/CFO/SEC
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Name | CHANNON MELLISA MITCHELL
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Credential |
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Telephone | 323-529-3269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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