Provider Demographics
NPI:1861456436
Name:PREMIER HOME AND COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:PREMIER HOME AND COMMUNITY SERVICES, INC.
Other - Org Name:PREMIER HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:BSCHCE
Authorized Official - Phone:972-681-7800
Mailing Address - Street 1:1666 N HAMPTON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2390
Mailing Address - Country:US
Mailing Address - Phone:972-681-7800
Mailing Address - Fax:972-681-7804
Practice Address - Street 1:1666 N HAMPTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2390
Practice Address - Country:US
Practice Address - Phone:972-681-7800
Practice Address - Fax:972-681-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010484251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1679987Medicaid
TX679392Medicare ID - Type UnspecifiedPROVIDER NUMBER