Provider Demographics
NPI:1568860997
Name:PREMIER HEALTH HOMES INC
Entity Type:Organization
Organization Name:PREMIER HEALTH HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LIIBAAN
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-307-9898
Mailing Address - Street 1:2817 ANTHONY LN S STE 205
Mailing Address - Street 2:
Mailing Address - City:ST ANTHONY
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2490
Mailing Address - Country:US
Mailing Address - Phone:651-307-9898
Mailing Address - Fax:651-318-0955
Practice Address - Street 1:2817 ANTHONY LN S STE 205
Practice Address - Street 2:
Practice Address - City:ST ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55418-2490
Practice Address - Country:US
Practice Address - Phone:651-307-9898
Practice Address - Fax:651-318-0955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health