Provider Demographics
NPI:1942745492
Name:PSP FAMILY CARE LLC
Entity Type:Organization
Organization Name:PSP FAMILY CARE LLC
Other - Org Name:PREMIER FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:210-344-5437
Mailing Address - Street 1:10609 W IH 10 STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1673
Mailing Address - Country:US
Mailing Address - Phone:210-344-5437
Mailing Address - Fax:210-340-1259
Practice Address - Street 1:10609 W IH 10 STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1673
Practice Address - Country:US
Practice Address - Phone:210-344-5437
Practice Address - Fax:210-340-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health