Provider Demographics
NPI:1801205075
Name:PREMIER HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:PREMIER HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-204-7930
Mailing Address - Street 1:790 E COLORADO BLVD
Mailing Address - Street 2:SUITE 850
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2113
Mailing Address - Country:US
Mailing Address - Phone:626-204-7930
Mailing Address - Fax:626-204-7950
Practice Address - Street 1:3 WATERS PARK DR
Practice Address - Street 2:SUITE 225
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1160
Practice Address - Country:US
Practice Address - Phone:650-242-4332
Practice Address - Fax:855-339-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health