Healthcare Provider Details
I. General information
NPI: 1144150350
Provider Name (Legal Business Name): PREMIERE ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9469 BIRDWOOD ST
PALM BEACH GARDENS FL
33410-5824
US
IV. Provider business mailing address
9469 BIRDWOOD ST
PALM BEACH GARDENS FL
33410-5824
US
V. Phone/Fax
- Phone: 561-503-7653
- Fax:
- Phone: 561-503-7653
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CARLINE
DEVILAS
Title or Position: PRESIDENT
Credential:
Phone: 561-503-7653