Organization
ODESSA PREMIUM CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN GIL LLANES (MANAGER)
(702) 985-1399
Entity
Organization
Contact information
Practice address
620 N GRANT AVE STE 903, ODESSA, TX 79761-4547
(702) 376-2485
Mailing address
620 N GRANT AVE STE 903, ODESSA, TX 79761-4547
(702) 376-2485
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
Update your record
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