Healthcare Provider Details

I. General information

NPI: 1801719315
Provider Name (Legal Business Name): PREMIER LIVING HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15487 OAK LN STE 200H
GULFPORT MS
39503-2664
US

IV. Provider business mailing address

15487 OAK LN STE 200H
GULFPORT MS
39503-2664
US

V. Phone/Fax

Practice location:
  • Phone: 228-383-9048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAQUISHA ARBUTHNOT
Title or Position: OWNER/DIRECTOR OF OPERATIONS
Credential: RN
Phone: 228-383-9048