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Organization
PREMIER HEALTHCARE SERVICES, LLC
Active
Organization
PREMIER HEALTHCARE SERVICES, LLC
Active
Other names
Aveanna Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BUCKHALTER (CFO)
(470) 464-8000
Entity
Organization
Contact information
Practice address
625 THE CITY DR S, SUITE 390, ORANGE, CA 92868-4924
(714) 834-1442
(714) 619-7666
Mailing address
400 INTERSTATE NORTH PKWY SE STE 1600, ATLANTA, GA 30339-5047
(470) 464-8000
(770) 248-8192
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
550000829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134306970
MEDICARE CMS 855A REQUIREMENT
CA
Enumeration date
11/11/2008
Last updated
01/28/2025
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