Provider Demographics
NPI:1871513481
Name:PREMIER SENIOR SERVICES
Entity type:Organization
Organization Name:PREMIER SENIOR SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GOBBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-323-9191
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-0061
Mailing Address - Country:US
Mailing Address - Phone:970-323-9191
Mailing Address - Fax:970-323-9194
Practice Address - Street 1:419 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425-0061
Practice Address - Country:US
Practice Address - Phone:970-323-9191
Practice Address - Fax:970-323-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83437720Medicaid