# LEGACY PREMEIR HEALTHCARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LEGACY PREMEIR HEALTHCARE SERVICES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649883158
- **Authorized official:** ZARETTE MECHELLE PARKER RN (OWNER)
- **Authorized official phone:** (321) 295-1314

## Contact information

- **Practice address:** 213 22ND ST NE, BRADENTON, FL 34208-1631
- **Practice address phone:** (321) 295-1314
- **Mailing address:** 581 N PARK AVE UNIT 2472, APOPKA, FL 32704-8707
- **Mailing address phone:** (321) 356-7792

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 08/25/2020
- **Last updated:** 08/25/2020