Provider Demographics
NPI:1730208240
Name:CONCENTRIC HEALTHCARE SOLUTIONS
Entity type:Organization
Organization Name:CONCENTRIC HEALTHCARE SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PESTOW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-444-7788
Mailing Address - Street 1:4250 N DRINKWATER BLVD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3981
Mailing Address - Country:US
Mailing Address - Phone:480-444-7788
Mailing Address - Fax:480-444-7799
Practice Address - Street 1:4250 N DRINKWATER BLVD
Practice Address - Street 2:SUITE 165
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3981
Practice Address - Country:US
Practice Address - Phone:480-444-7788
Practice Address - Fax:480-444-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA4068251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZHHA4068OtherLICENSED HOME HEALTH AGEN