Premium Home Care Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PREMIUM HOME CARE SERVICES LLC

Practice address

35 Baker St
Brockton, MA 02302-4302

Phone

(857) 207-5175

NPI assigned

Oct 2, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mariolette GourgueNPI 1467395806

Title

Executive Director

Phone

(857) 207-5175

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mariolette M Gourgue

  • Licensed Practical Nurse
  • Brockton, MA
  • NPI 1467395806
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1245058627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BAKER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023024302",
            "telephone_number": "857-207-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BAKER ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023024302",
            "telephone_number": "857-207-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM HOME CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "GOURGUE",
        "authorized_official_first_name": "MARIOLETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "857-207-5175"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Zofia Pratt
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• Denise Marie Prefontaine, RN BS LMHC
• Premier Dentistry, LLC
• Premium Care Chiropractic Corp
• Michele Marie Prendergast, OTR/L
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• Kathleen P Pringle, CNM

• In Home Supportive Care Agency in Brockton, MA
• Providers in Brockton, MA by specialty
• In Home Supportive Care Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.