# PREMIUM IN-HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PREMIUM IN-HOME CARE LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699040725
- **Authorized official:** BASHEER HAJI MOHAMMAD (PRESIDENT)
- **Authorized official phone:** (314) 827-9045

## Contact information

- **Practice address:** 4065 S GRAND BLVD STE 100, SAINT LOUIS, MO 63118-3418
- **Practice address phone:** (314) 827-9045
- **Practice address fax:** (314) 657-0179
- **Mailing address:** 4065 S GRAND BLVD STE 100, SAINT LOUIS, MO 63118-3418
- **Mailing address phone:** (314) 827-9045
- **Mailing address fax:** (314) 657-0179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | MO | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | MO | — |

## Other

- **Enumeration date:** 03/22/2012
- **Last updated:** 10/09/2020