Provider Demographics
NPI:1891007597
Name:PREMIER AGING IN PLACE SERVICES, INC.
Entity Type:Organization
Organization Name:PREMIER AGING IN PLACE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:CBC, CEAC, CAPS
Authorized Official - Phone:407-373-7247
Mailing Address - Street 1:2454 E MICHIGAN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5059
Mailing Address - Country:US
Mailing Address - Phone:407-373-7247
Mailing Address - Fax:407-895-1261
Practice Address - Street 1:2454 E MICHIGAN ST
Practice Address - Street 2:SUITE E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5059
Practice Address - Country:US
Practice Address - Phone:407-373-7247
Practice Address - Fax:407-895-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBC1254610171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty