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General NPI Number Information
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NPI Number | 1164005906
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Entity Type | Organization
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Legal Business Name | CONCERNED CARE PALLIATIVE SERVICES LLC
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Dates
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Enumeration Date | 04/29/2021
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 3621 RIDGELAKE DR STE 201
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City | METAIRIE
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State | LA
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Zip | 70002-1739
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Country | US
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Telephone | 985-892-3947
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Fax | 504-518-5749
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Provider Business Mailing Address
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Address Line | 110 WISTERIA DR
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City | PASS CHRISTIAN
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State | MS
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Zip | 39571-4728
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Country | US
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Telephone | 985-960-3211
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Fax | 504-210-1978
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JODY MARTIN
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Credential |
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Telephone | 985-960-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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