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General NPI Number Information
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NPI Number | 1518275767
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Entity Type | Organization
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Legal Business Name | PREMIER HOME CARE, INC
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 301 HWY 24 N
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City | BUENA VISTA
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State | CO
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Zip | 81211
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Country | US
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Telephone | 719-395-3124
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Fax | 719-395-3128
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Provider Business Mailing Address
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Address Line | PO BOX 5007 301 HWY 24 N
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City | BUENA VISTA
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State | CO
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Zip | 81211-5007
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Country | US
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Telephone | 719-395-3124
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Fax | 719-395-3128
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Authorized Official
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Title or Position | CEO
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Name | LAWANNA LOU BEST
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Credential | RN
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Telephone | 719-395-3124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 160003053
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 8425
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License Number State | CO
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