# PREMIUM PERSONAL HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premium Personal Home Care LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659090595
- **Authorized official:** OSLEIDIS PEREZ LAGO (MEDICAL ASSISTANT)
- **Authorized official phone:** (432) 556-7841

## Contact information

- **Practice address:** 3801 N COUNTY ROAD 1140, MIDLAND, TX 79705-9609
- **Practice address phone:** (432) 270-6074
- **Practice address fax:** (432) 260-6077
- **Mailing address:** 3801 N COUNTY ROAD 1140, MIDLAND, TX 79705-9609
- **Mailing address phone:** (432) 270-6074
- **Mailing address fax:** (432) 260-6077

## Taxonomy

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

## Other

- **Enumeration date:** 08/24/2022
- **Last updated:** 09/21/2022