Organization
PREMIER GROUP HOME
Active
Other names
Premier Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
KEMLIE B DORT (ADMINISTRATOR)
(561) 568-5008
Entity
Organization
Contact information
Practice address
1122 ESSEX DR, WELLINGTON, FL 33414-5606
(561) 568-5008
Mailing address
1122 ESSEX DR, WELLINGTON, FL 33414-5606
(561) 568-5008
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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