Provider Demographics
NPI:1366880189
Name:HEAVEN SENT CONCIERGE SERVICES
Entity type:Organization
Organization Name:HEAVEN SENT CONCIERGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-906-4972
Mailing Address - Street 1:PO BOX 271892
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78427-1892
Mailing Address - Country:US
Mailing Address - Phone:361-462-5401
Mailing Address - Fax:361-299-5619
Practice Address - Street 1:4625 WALES DR
Practice Address - Street 2:#4
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4319
Practice Address - Country:US
Practice Address - Phone:361-462-5401
Practice Address - Fax:361-299-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care