Provider Demographics
NPI:1982721965
Name:PREMIER HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:PREMIER HOME HEALTH CARE SERVICES, INC.
Other - Org Name:PREMIER HOME HEALTH CARE OF CONNECTICUT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTZLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-7722
Mailing Address - Street 1:1 N LEXINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1712
Mailing Address - Country:US
Mailing Address - Phone:914-428-7722
Mailing Address - Fax:914-428-2404
Practice Address - Street 1:19 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3432
Practice Address - Country:US
Practice Address - Phone:203-438-3811
Practice Address - Fax:203-226-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005251E00000X, 251J00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0005OtherSTATE LICENSE NUMBER