Organization
CONCORD HOME HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENNY RONKE THORPE (ADMINISTRATOR)
(817) 465-5001
Entity
Organization
Contact information
Practice address
2305 OAK LN STE 209, GRAND PRAIRIE, TX 75051-8241
(817) 465-5001
(817) 465-5002
Mailing address
2305 OAK LN STE 209, GRAND PRAIRIE, TX 75051-8241
(817) 465-5001
(817) 465-5002
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
008830
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001013743
PHC
TX
01
—
001025738
CDSA PHC PROGRAM
TX
01
—
001025739
CDSA MDCP PROGRAM
TX
01
—
001025740
CDSA CLASS PROGRAM
TX
01
—
1014156
CBA
TX
05
—
164342101
—
TX
Enumeration date
10/05/2006
Last updated
10/12/2018
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