Basic Information
| Provider Information | |||||||||
| NPI: | 1790181246 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREMIER HEALTHCARE SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 790 E COLORADO BLVD | ||||||||
| Address2: | SUITE 850 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911012113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262047930 | ||||||||
| FaxNumber: | 6262047950 | ||||||||
| Practice Location | |||||||||
| Address1: | 1450 N TUSTIN AVE | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927058640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262047930 | ||||||||
| FaxNumber: | 6262047950 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2014 | ||||||||
| LastUpdateDate: | 11/11/2014 | ||||||||
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| AuthorizedOfficialLastName: | MALLINGER | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6262047930 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.