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Organization

EAST TEXAS PHC, LLC

Active
Other names
Premier HomeCare
Organization subpart
No

Provider details

NPI number
Authorized official
TRACIE JONES (ADMINISTRATOR)
(903) 753-2273
Entity
Organization

Contact information

Practice address
602 E WHALEY ST, LONGVIEW, TX 75601-6525
(903) 753-2273
(903) 753-2274
Mailing address
823 N 4TH ST, LONGVIEW, TX 75601-5414
(903) 753-2273

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011536
TDH LICENSE
TX
Enumeration date
06/07/2007
Last updated
07/29/2024
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