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General NPI Number Information
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NPI Number | 1316358740
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Entity Type | Organization
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Legal Business Name | PRIME HHA, LLC
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 3454 OAK ALLEY CT STE 500
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City | TOLEDO
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State | OH
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Zip | 43606-1356
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Country | US
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Telephone | 419-535-1414
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Fax | 419-469-5469
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Provider Business Mailing Address
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Address Line | 33 S STATE ST FL 5
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City | CHICAGO
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State | IL
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Zip | 60603-2804
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Country | US
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Telephone | 312-762-9999
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER
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Name | JOSEPH PATRICK BONACCORSI
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Credential |
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Telephone | 312-762-9999
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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 |
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License Number State | OH
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