Healthcare Provider Details

I. General information

NPI: 1518861236
Provider Name (Legal Business Name): PREMIER ELDERLY ASSISTANCE IN RESIDENTIAL LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 VANDAL WAY
PALMDALE CA
93551-4592
US

IV. Provider business mailing address

744 VANDAL WAY
PALMDALE CA
93551-4592
US

V. Phone/Fax

Practice location:
  • Phone: 661-645-2512
  • Fax:
Mailing address:
  • Phone: 661-645-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSEPH MAGAT
Title or Position: CEO
Credential:
Phone: 661-645-2512