Provider Demographics
NPI:1164741807
Name:PREMIERE HEALTHCARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PREMIERE HEALTHCARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RN, ANP-BC
Authorized Official - Phone:303-277-9455
Mailing Address - Street 1:6310 UMBER CIR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80403-7407
Mailing Address - Country:US
Mailing Address - Phone:303-277-9455
Mailing Address - Fax:
Practice Address - Street 1:6310 UMBER CIR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80403-7407
Practice Address - Country:US
Practice Address - Phone:303-277-9455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51561261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center