Provider Demographics
NPI:1871394510
Name:PRIME SERVICE, INC.
Entity type:Organization
Organization Name:PRIME SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-765-2952
Mailing Address - Street 1:7332 SIDNEY DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2917
Mailing Address - Country:US
Mailing Address - Phone:916-765-2952
Mailing Address - Fax:
Practice Address - Street 1:7332 SIDNEY DR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-2917
Practice Address - Country:US
Practice Address - Phone:916-560-3148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility