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General NPI Number Information
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NPI Number | 1881370062
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Entity Type | Organization
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Legal Business Name | CONCIERGE CARE LLC
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 8867 BLUE RIVER DR
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City | VALLEJO
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State | CA
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Zip | 94591-8724
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Country | US
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Telephone | 510-260-5481
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Fax | 209-259-1490
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Provider Business Mailing Address
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Address Line | 8867 BLUE RIVER DR
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City | VALLEJO
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State | CA
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Zip | 94591-8724
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Country | US
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Telephone | 510-260-5481
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Fax | 209-259-1490
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Authorized Official
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Title or Position | OWNER
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Name | MS. IRENE J JOHNSON-BULLOCK
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Credential |
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Telephone | 510-260-5481
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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 |
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License Number State |
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