Provider Demographics
NPI:1700538253
Name:PREMIER LIFE HOME HEALTH CARE
Entity Type:Organization
Organization Name:PREMIER LIFE HOME HEALTH CARE
Other - Org Name:PREMIER LIFE PRIVATE HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:SETINA
Authorized Official - Last Name:ARHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-835-0189
Mailing Address - Street 1:226 MISTY GROVE DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6615
Mailing Address - Country:US
Mailing Address - Phone:804-835-0189
Mailing Address - Fax:
Practice Address - Street 1:226 MISTY GROVE DR
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-6615
Practice Address - Country:US
Practice Address - Phone:804-835-0189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty