21D2144126 CLIA NUMBER - CONCERTED CARE GROUP, LLC - BROOKLYN

Laboratory Demographics

CLIA Number: 21D2144126

Facility Name: CONCERTED CARE GROUP, LLC - BROOKLYN

Facility Address:
112 PATAPSCO AVENUE
BALTIMORE, MD
ZIP 21225
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Facility Phone Number: 410 617-0142

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1477958346

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name	Field Value
CLIA Number	21D2144126
LAB Type	Community Clinic
Facility Name	CONCERTED CARE GROUP, LLC - BROOKLYN
Street	112 PATAPSCO AVENUE
City	BALTIMORE
State	MD
ZIP	21225
Phone	410 617-0142
CertificateType	4
CertificateEffectiveDate	2/12/2024
CertificateExpirationDate	2/11/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024