Provider Demographics
NPI:1831167782
Name:PREMIER HEALTH ASSOCIATES, INC.
Entity type:Organization
Organization Name:PREMIER HEALTH ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:TREASE
Authorized Official - Last Name:JANSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, CCC-SLP
Authorized Official - Phone:515-223-6620
Mailing Address - Street 1:1454 30TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1312
Mailing Address - Country:US
Mailing Address - Phone:515-223-6620
Mailing Address - Fax:515-222-3962
Practice Address - Street 1:1454 30TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1312
Practice Address - Country:US
Practice Address - Phone:515-223-6620
Practice Address - Fax:515-222-3962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA66519OtherWELLMARK BC/BS
IAI10279OtherNORIDIAN MEDICARE PART B
IA0665190Medicaid
IA=========OtherTRIWEST
IA=========OtherTRIWEST