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General NPI Number Information
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NPI Number | 1376264341
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Entity Type | Organization
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Legal Business Name | CONCIERGE CARE OF NE FLORIDA, LLC
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 1857 WELLS RD STE 224
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City | ORANGE PARK
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State | FL
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Zip | 32073-2340
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Country | US
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Telephone | 904-530-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 6817 SOUTHPOINT PKWY STE 1004
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8201
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Country | US
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Telephone | 904-534-1655
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | NANCY RALSTON
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Credential | RN
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Telephone | 904-534-1655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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