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General NPI Number Information
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NPI Number | 1730767757
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Entity Type | Organization
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Legal Business Name | CONCIERGE SERVICES
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 24777 N CORBIN HILL RD
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City | ATHOL
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State | ID
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Zip | 83801-8677
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Country | US
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Telephone | 208-964-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1105
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City | ATHOL
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State | ID
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Zip | 83801-1105
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Country | US
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Telephone | 208-964-6000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID BOCHENEK
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Credential |
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Telephone | 208-964-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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