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General NPI Number Information
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NPI Number | 1952158073
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Entity Type | Organization
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Legal Business Name | PRIMELIVING HOME HEALTH THERAPY, INC.
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 48521 WARM SPRINGS BLVD STE 307A
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City | FREMONT
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State | CA
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Zip | 94539-7796
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Country | US
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Telephone | 708-895-0381
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 BERNICE RD STE 7
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City | LANSING
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State | IL
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Zip | 60438-6046
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Country | US
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Telephone | 708-895-0381
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. TIMOTHY J PLONSEY
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Credential |
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Telephone | 708-895-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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