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General NPI Number Information
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NPI Number | 1811371065
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Entity Type | Organization
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Legal Business Name | CONCERNED COMPANION CARE
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 5971 SUITE C NEW JESUP HWY
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City | BRUNSWICK
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State | GA
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Zip | 31525-9518
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Country | US
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Telephone | 912-324-8177
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Fax | 912-342-8151
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Provider Business Mailing Address
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Address Line | 5971 SUITE C NEW JESUP HWY
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City | BRUNSWICK
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State | GA
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Zip | 31525-9518
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Country | US
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Telephone | 912-324-0696
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAXINE HELEN CAMPBELL
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Credential |
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Telephone | 912-242-1130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 063-R-1722
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License Number State | GA
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