# PREMIER HOME HEALTH AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003219007
- **Authorized official:** MS. HEATHER D BLANCHART (OFFICE MANAGER)
- **Authorized official phone:** (928) 377-1004

## Contact information

- **Practice address:** 3555 WESTERN AVE, KINGMAN, AZ 86409
- **Practice address phone:** (928) 377-1004
- **Practice address fax:** (928) 757-7179
- **Mailing address:** 3555 WESTERN AVE, KINGMAN, AZ 86409-3011
- **Mailing address phone:** (928) 377-1004
- **Mailing address fax:** (928) 757-7179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HHA6631 | AZ | Yes |

## Other

- **Enumeration date:** 10/03/2014
- **Last updated:** 06/30/2015