Provider Demographics
NPI:1184375362
Name:PREMIERE QUALITY HEALTH CENTER INC
Entity type:Organization
Organization Name:PREMIERE QUALITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESHA
Authorized Official - Middle Name:DUSHON
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:313-635-5978
Mailing Address - Street 1:12048 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-1836
Mailing Address - Country:US
Mailing Address - Phone:313-491-0003
Mailing Address - Fax:
Practice Address - Street 1:12048 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-1836
Practice Address - Country:US
Practice Address - Phone:313-635-5978
Practice Address - Fax:313-635-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty