Provider Demographics
NPI:1952158073
Name:PRIMELIVING HOME HEALTH THERAPY, INC.
Entity Type:Organization
Organization Name:PRIMELIVING HOME HEALTH THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLONSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-895-0381
Mailing Address - Street 1:1905 BERNICE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-6046
Mailing Address - Country:US
Mailing Address - Phone:708-895-0381
Mailing Address - Fax:
Practice Address - Street 1:48521 WARM SPRINGS BLVD STE 307A
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7796
Practice Address - Country:US
Practice Address - Phone:708-895-0381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy