Provider Demographics
NPI:1811720444
Name:PREMIUM HANDS HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PREMIUM HANDS HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUQAYYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:EJALONIBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-310-7771
Mailing Address - Street 1:18635 GREENWOOD MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4605
Mailing Address - Country:US
Mailing Address - Phone:832-310-7771
Mailing Address - Fax:
Practice Address - Street 1:18635 GREENWOOD MEADOW TRL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4605
Practice Address - Country:US
Practice Address - Phone:832-310-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities