Provider Demographics
NPI:1922691211
Name:PRIME ACQUISITIONS, LLC
Entity Type:Organization
Organization Name:PRIME ACQUISITIONS, LLC
Other - Org Name:NEW HORIZONS PACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN
Authorized Official - Phone:314-897-7002
Mailing Address - Street 1:5035 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2011
Mailing Address - Country:US
Mailing Address - Phone:314-587-7958
Mailing Address - Fax:314-558-6021
Practice Address - Street 1:5035 MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2011
Practice Address - Country:US
Practice Address - Phone:314-897-7223
Practice Address - Fax:314-558-6021
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIME ACQUISITIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-17
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization