Provider Demographics
NPI:1033458690
Name:PREMIER HOME CARE OF SOUTHERN ARIZONA, INC.
Entity Type:Organization
Organization Name:PREMIER HOME CARE OF SOUTHERN ARIZONA, INC.
Other - Org Name:HOMEWATCH CAREGIVERS OF TUCSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:LANNON
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:520-297-9349
Mailing Address - Street 1:3483 W COURTNEY CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3250
Mailing Address - Country:US
Mailing Address - Phone:520-297-9349
Mailing Address - Fax:520-297-3100
Practice Address - Street 1:3483 W COURTNEY CROSSING LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3250
Practice Address - Country:US
Practice Address - Phone:520-297-9349
Practice Address - Fax:520-297-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care