Organization
PREMIUM HOME CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIOLETTE GOURGUE (EXECUTIVE DIRECTOR)
(857) 207-5175
Entity
Organization
Contact information
Practice address
35 BAKER ST, BROCKTON, MA 02302-4302
(857) 207-5175
Mailing address
35 BAKER ST, BROCKTON, MA 02302-4302
(857) 207-5175
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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