NPIMap

Organization Active NPI

Concrete Rose LLC

  • Case Management Agency
  • Spokane, WA
National Provider Identifier
1619650207
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CONCRETE ROSE LLC
Practice address
621 S Adams St Apt 6
Spokane, WA 99204-3259
Phone
(206) 866-4213
NPI assigned
Aug 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Breianna Marie Gorder
Title
Executive Director
Phone
(206) 866-4213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

621 S Adams St Apt 6
Spokane, WA 99204-3259

Mailing address

621 S Adams St Apt 6
Spokane, WA 99204-3259
Phone (206) 866-4213

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1619650207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ADAMS ST APT 6",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043259",
            "telephone_number": "206-866-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S ADAMS ST APT 6",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043259",
            "telephone_number": "206-866-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCRETE ROSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "GORDER",
        "authorized_official_first_name": "BREIANNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-866-4213"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.