Provider Demographics
NPI:1316560634
Name:PREMIUM TOUCH OF CARE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:PREMIUM TOUCH OF CARE ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NACCOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT-HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-335-9047
Mailing Address - Street 1:141 TRACTION ST STE 43
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-4725
Mailing Address - Country:US
Mailing Address - Phone:864-335-9047
Mailing Address - Fax:864-335-9867
Practice Address - Street 1:141 TRACTION ST STE 43
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-4725
Practice Address - Country:US
Practice Address - Phone:864-335-9047
Practice Address - Fax:864-335-9867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
11160826OtherNEW APPLICANT