Premium Homecare Agency LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PREMIUM HOMECARE AGENCY LLC

Practice address

89 Green Lodge St
Canton, MA 02021-1131

Phone

(781) 298-7112

NPI assigned

Jul 11, 2019

Last updated

Jul 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clarince Jean Baptiste

Title

Owner

Phone

(954) 305-5263

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1942852751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 GREEN LODGE ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211131",
            "telephone_number": "781-298-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 GREEN LODGE ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211131",
            "telephone_number": "781-298-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM HOMECARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "JEAN BAPTISTE",
        "authorized_official_first_name": "CLARINCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-305-5263"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.