Provider Demographics
NPI:1578392247
Name:PREMIER HOME CARE PROVIDER LLC
Entity type:Organization
Organization Name:PREMIER HOME CARE PROVIDER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LIVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-635-1859
Mailing Address - Street 1:622 EL PRADO APT 4
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-1977
Mailing Address - Country:US
Mailing Address - Phone:561-698-4235
Mailing Address - Fax:
Practice Address - Street 1:1489 N MILITARY TRL STE 115
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6057
Practice Address - Country:US
Practice Address - Phone:561-698-4235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health