Organization
A PREMIER HOME PROVIDER SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA D GUTIERREZ (CFO/OWNER)
(239) 200-9073
Entity
Organization
Contact information
Practice address
9990 COCONUT RD STE 260, ESTERO, FL 34135-8488
(239) 200-9073
Mailing address
9990 COCONUT RD STE 260, ESTERO, FL 34135-8488
(239) 200-9073
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
08/13/2019
Last updated
09/25/2022
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