NPIMap

Organization Active NPI

Premier Healthcare Services, LLC

Doing business as Aveanna Healthcare

  • Home Health Agency
  • Alameda, CA
National Provider Identifier
1396064093
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
550001472 Issued in CA
Legal business name
PREMIER HEALTHCARE SERVICES, LLC
Doing business as
Aveanna Healthcare
Practice address
1320 Harbor Bay Pkwy Ste 257
Alameda, CA 94502-6578
Phone
(510) 568-2201
Fax
(877) 509-7035
NPI assigned
May 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Matthew Buckhalter
Title
Cfo
Phone
(470) 464-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 550001472 CA Primary

Addresses

Primary practice location

1320 Harbor Bay Pkwy Ste 257
Alameda, CA 94502-6578

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other names 1

  • Aveanna Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101008000004 CA Part A Provider - Home Health Agency 2264517697 Practice locations: Oakland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396064093. Details of each certification follow.

Home health agency certification: CCN 059348

Legal name
PREMIER HEALTHCARE SERVICES, LLC
Doing business as
AVEANNA HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 10, 2011
Last certification
Oct 18, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 7, 2005 in CA
Enrollment address
333 Hegenberger Rd
Ste 201
Oakland, CA 94621-1452

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Care Compare: Home health agency

Medicare Care Compare
Listed as
Aveanna HealthcareCCN 059348 · All quality measures
Ownership
Proprietary
Certified
Nov 10, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2015952Premier Healthcare Services, LLC333 Hegenberger Rd Ste 201, Oakland, CA 94621Certificate of waiverNov 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Premier Healthcare Services LLC24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

1000 Atlantic Ave
Ste 112
Alameda, CA 94501
Phone (510) 568-2201

333 Hegenberger Rd
Ste 201
Oakland, CA 94621
Phone (510) 568-2201

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
J.H. Whitney VII LP Organization, New Canaan, CT 5% Or Greater Indirect Ownership Interest Jul 1, 2018 17.09%
Psa Healthcare Investment Holding LLC Organization, New Canaan, CT LLC 5% Or Greater Indirect Ownership Interest Jul 1, 2018 11.07%
Aveanna Healthcare LLC Organization, Atlanta, GA LLC 5% Or Greater Direct Ownership Interest Jul 1, 2018 100%
Aveanna Healthcare Intermediate Holdings LLC Organization, Atlanta, GA Holding company 5% Or Greater Indirect Ownership Interest Jul 1, 2018 100%
Psa Healthcare Holding LLC Organization, New Canaan, CT LLC 5% Or Greater Indirect Ownership Interest Jul 1, 2018 8.54%
Aveanna Healthcare Holdings Inc Organization, Atlanta, GA Holding company 5% Or Greater Indirect Ownership Interest Jul 1, 2018 100%
David Afshar Individual Corporate OfficerCfo Jul 1, 2018
Bcip Associates IV US L.P. Organization, Boston, MA 5% Or Greater Indirect Ownership Interest Jul 1, 2018 5.67%
Hamilton Lane Co-Investment Fund III Holdings - 2 LP Organization, Bala Cynwyd, PA 5% Or Greater Indirect Ownership Interest Jul 1, 2018 9.33%
Rodney Windley Individual Corporate Director Jul 1, 2018
Bain Capital Fund XI LP Organization, Boston, MA 5% Or Greater Indirect Ownership Interest Jul 1, 2018 37.65%
Harmon a Strange Individual Corporate OfficerCeo/President Jul 1, 2018
Shannon L Drake Individual Corporate OfficerLegal Officer/Secretary Jul 1, 2018
Baobay Vang Individual W-2 Managing EmployeeAdministrator Nov 20, 2020
Jeffrey Shaner Individual Corporate Officer Jul 1, 2018

Facilities with the same owner 122

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Stevenson Ranch, CA
    • NPI 1093946238

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • West Covina, CA
    • NPI 1104058122

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare Investment Holding LLC

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Sherman Oaks, CA
    • NPI 1114159381

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • San Jose, CA
    • NPI 1114246816

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Torrance, CA
    • NPI 1134306970

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare Investment Holding LLC

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Sacramento, CA
    • NPI 1275764417

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthacare

    • Home Health Agency
    • Victorville, CA
    • NPI 1295159366

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare Investment Holding LLC

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Orange, CA
    • NPI 1326292897

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare Investment Holding LLC

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • San Diego, CA
    • NPI 1437385010

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Culver City, CA
    • NPI 1437400165

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Temecula, CA
    • NPI 1669600284

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare in

    CMS ownership
  • Premier Healthcare Services, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Palmdale, CA
    • NPI 1811238967

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare Investment Holding LLC

    CMS ownership
View all 122

NPI Registry JSON

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1396064093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 HARBOR BAY PKWY STE 257",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945026578",
            "telephone_number": "510-568-2201",
            "fax_number": "877-509-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-20",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550001472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.