# PRIME PROFESSIONAL HOME HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prime Professional Home Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528606068
- **Authorized official:** SIMONE DESIREE KING (OWNER)
- **Authorized official phone:** (804) 892-0604

## Contact information

- **Practice address:** 13515A LAWING DR, SOUTH CHESTERFIELD, VA 23834-6018
- **Practice address phone:** (804) 892-0604
- **Practice address fax:** (804) 796-6257
- **Mailing address:** 13515A LAWING DR, SOUTH CHESTERFIELD, VA 23834-6018
- **Mailing address phone:** (804) 892-0604
- **Mailing address fax:** (804) 796-6257

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2019
- **Last updated:** 12/16/2019