Healthcare Provider Details

I. General information

NPI: 1295184190
Provider Name (Legal Business Name): A PREMIER SENIOR HOME CARE ACQUISITIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W CHOCTAW AVE
CHICKASHA OK
73018-2634
US

IV. Provider business mailing address

6760 OLD JACKSONVILLE HWY STE 101
TYLER TX
75703-0566
US

V. Phone/Fax

Practice location:
  • Phone: 580-366-4237
  • Fax: 888-411-3004
Mailing address:
  • Phone: 855-485-8273
  • Fax: 405-835-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC8015
License Number StateOK

VIII. Authorized Official

Name: KATRINA DAWN LANIER
Title or Position: SECRETARY
Credential:
Phone: 855-485-8273