Provider Demographics
NPI:1629761531
Name:PREMIER AT HOME HOSPICE & PALLIATIVE CARE L.L.C
Entity Type:Organization
Organization Name:PREMIER AT HOME HOSPICE & PALLIATIVE CARE L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:JERELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKITCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:586-925-0115
Mailing Address - Street 1:23135 21 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-5182
Mailing Address - Country:US
Mailing Address - Phone:586-925-0115
Mailing Address - Fax:
Practice Address - Street 1:23135 21 MILE RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5182
Practice Address - Country:US
Practice Address - Phone:586-925-0115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based