Provider Demographics
NPI:1114949609
Name:PREMIER HOME CARE INC
Entity Type:Organization
Organization Name:PREMIER HOME CARE INC
Other - Org Name:PREMIER THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LAWANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:719-395-3124
Mailing Address - Street 1:PO BOX 5007
Mailing Address - Street 2:28350 CR 317, SUITE 1
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-5007
Mailing Address - Country:US
Mailing Address - Phone:719-395-3124
Mailing Address - Fax:719-395-3128
Practice Address - Street 1:28350 CR 317
Practice Address - Street 2:SUITE 1
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211-5007
Practice Address - Country:US
Practice Address - Phone:719-395-3124
Practice Address - Fax:719-395-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO54229863Medicaid
CO54229863Medicaid