Provider Demographics
NPI:1467048397
Name:PRIME VALUE HOME CARE LLC
Entity Type:Organization
Organization Name:PRIME VALUE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FOLASADE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPOOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-456-4116
Mailing Address - Street 1:507 N SAM HOUSTON PKWY E STE 584
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4021
Mailing Address - Country:US
Mailing Address - Phone:281-456-4116
Mailing Address - Fax:281-456-4108
Practice Address - Street 1:507 N SAM HOUSTON PKWY E STE 584
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4021
Practice Address - Country:US
Practice Address - Phone:708-623-4675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care