Provider Demographics
NPI:1477550218
Name:PRIORITY ONE HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:PRIORITY ONE HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARBONELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-439-0455
Mailing Address - Street 1:28091 DEQUINDRE RD STE 211
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3070
Mailing Address - Country:US
Mailing Address - Phone:248-439-0455
Mailing Address - Fax:248-439-0456
Practice Address - Street 1:28091 DEQUINDRE RD STE 211
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3070
Practice Address - Country:US
Practice Address - Phone:248-439-0455
Practice Address - Fax:248-439-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI03301C251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
237463Medicare Oscar/Certification