Provider Demographics
NPI:1720037674
Name:PREFERRED HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PREFERRED HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:HOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, CDE
Authorized Official - Phone:407-855-5728
Mailing Address - Street 1:12701 S JOHN YOUNG PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-3423
Mailing Address - Country:US
Mailing Address - Phone:407-855-5728
Mailing Address - Fax:
Practice Address - Street 1:12701 S JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-3420
Practice Address - Country:US
Practice Address - Phone:407-855-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ16OtherBLUE CROSS/BLUE SHIELD
FL108156Medicare ID - Type UnspecifiedPROVIDER NUMBER