Provider Demographics
NPI:1821500166
Name:PREMIER HEALTHCARE SERVICES TEXAS LLC
Entity Type:Organization
Organization Name:PREMIER HEALTHCARE SERVICES TEXAS LLC
Other - Org Name:CHILD'S PLAY THERAPEUTIC HOMECARE INC.
Other - Org Type:Doing Business As
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 1:815 COLORADO BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1745
Mailing Address - Country:US
Mailing Address - Phone:626-204-7930
Mailing Address - Fax:
Practice Address - Street 1:8318 JONES MALTSBERGER RD STE 121
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6552
Practice Address - Country:US
Practice Address - Phone:210-348-7529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health