Provider Demographics
NPI:1528702669
Name:KC CONCIERGE SERVICES, LLC
Entity type:Organization
Organization Name:KC CONCIERGE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:GAYNOH
Authorized Official - Last Name:DORBOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:913-617-4548
Mailing Address - Street 1:8820 MONROVIA ST # 19494
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3539
Mailing Address - Country:US
Mailing Address - Phone:913-485-6136
Mailing Address - Fax:
Practice Address - Street 1:7611 W 156TH TER
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1719
Practice Address - Country:US
Practice Address - Phone:913-617-4548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS23-37681-092OtherLPN