Provider Demographics
NPI:1649929001
Name:ESTEEM CONCIERGE NURSING
Entity type:Organization
Organization Name:ESTEEM CONCIERGE NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANAGO GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-229-5248
Mailing Address - Street 1:2310 BAL HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7211
Mailing Address - Country:US
Mailing Address - Phone:832-568-3530
Mailing Address - Fax:
Practice Address - Street 1:2310 BAL HARBOUR DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7211
Practice Address - Country:US
Practice Address - Phone:832-568-3530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JDL VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health