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General NPI Number Information
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NPI Number | 1790181246
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTHCARE SERVICES, 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 | 1450 N TUSTIN AVE SUITE 140
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City | SANTA ANA
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State | CA
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Zip | 92705-8640
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Country | US
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Telephone | 626-204-7930
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Fax | 626-204-7950
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Provider Business Mailing Address
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Address Line | 790 E COLORADO BLVD SUITE 850
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City | PASADENA
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State | CA
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Zip | 91101-2113
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Country | US
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Telephone | 626-204-7930
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Fax | 626-204-7950
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH MALLINGER
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Credential |
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Telephone | 626-204-7930
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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 |
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