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General NPI Number Information
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NPI Number | 1053717587
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Entity Type | Organization
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Legal Business Name | PREMIER ELITE CARE, LLC
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Dates
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Enumeration Date | 11/11/2014
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Last Update Date | 11/11/2014
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Provider Practice Location Address
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Address Line | 2715 HALLECK DR
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City | WHITEHALL
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State | PA
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Zip | 18052-3832
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Country | US
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Telephone | 610-739-8690
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Fax |
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Provider Business Mailing Address
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Address Line | 2715 HALLECK DR
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City | WHITEHALL
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State | PA
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Zip | 18052-3832
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Country | US
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Telephone | 610-739-8690
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AKUA BOATENG
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Credential | M.S.W, LSW.
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Telephone | 610-739-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 24203601
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License Number State | PA
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