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General NPI Number Information
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NPI Number | 1528433190
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Entity Type | Organization
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Legal Business Name | PREMIER AGE CARE CORP
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 1115 W PIONEER PKWY
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City | ARLINGTON
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State | TX
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Zip | 76013-7624
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Country | US
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Telephone | 817-459-3312
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Fax | 817-459-3314
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Provider Business Mailing Address
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Address Line | 1115 W PIONEER PKWY
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City | ARLINGTON
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State | TX
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Zip | 76013-7624
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Country | US
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Telephone | 817-459-3312
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Fax | 817-459-3314
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AGNES STURGEON
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Credential |
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Telephone | 817-459-3312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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