# PREMIER GROUP HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Group Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851163075
- **Authorized official:** KEMLIE B DORT (ADMINISTRATOR)
- **Authorized official phone:** (561) 568-5008

## Contact information

- **Practice address:** 1122 ESSEX DR, WELLINGTON, FL 33414-5606
- **Practice address phone:** (561) 568-5008
- **Mailing address:** 1122 ESSEX DR, WELLINGTON, FL 33414-5606
- **Mailing address phone:** (561) 568-5008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2023
- **Last updated:** 10/23/2023