Organization
CONCIERGE HOME CARE OF PORT ST LUCIE LLC
Active
Other names
Concierge Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GREGORY YOUNG (SECRETARY & CAO)
(904) 733-1003
Entity
Organization
Contact information
Practice address
1840 SE PORT ST LUCIE BLVD STE 1840, PORT ST LUCIE, FL 34952-5545
(772) 777-2749
(772) 264-2900
Mailing address
4655 SALISBURY RD STE 110, JACKSONVILLE, FL 32256-0957
(904) 733-1003
(904) 448-8855
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2219901
CLIA WAIVER ID
FL
01
—
299995197
AHCA STATE LICENSE
FL
Enumeration date
10/16/2020
Last updated
12/27/2023
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