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General NPI Number Information
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NPI Number | 1417845611
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Entity Type | Organization
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Legal Business Name | 1 CARE CONCEPT SOLUTIONS CORP
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 126 PADDOCK PLACE DR
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City | MT JULIET
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State | TN
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Zip | 37122-6605
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Country | US
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Telephone | 214-364-6155
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 523
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City | MOUNT JULIET
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State | TN
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Zip | 37121-0523
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EBONY DELSHUN PORTER
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Credential |
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Telephone | 214-364-6155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 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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