Provider Demographics
NPI:1295030435
Name:PRIORITYCARE HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:PRIORITYCARE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:ROLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:661-267-0010
Mailing Address - Street 1:503 W AVENUE Q10
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4223
Mailing Address - Country:US
Mailing Address - Phone:661-267-0010
Mailing Address - Fax:661-267-0010
Practice Address - Street 1:503 W AVENUE Q10
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4223
Practice Address - Country:US
Practice Address - Phone:661-267-0010
Practice Address - Fax:661-267-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility