Provider Demographics
NPI:1225836604
Name:PRIME SERVICE, INC.
Entity type:Organization
Organization Name:PRIME SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-765-2952
Mailing Address - Street 1:5795 SAUNDERS AVE
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-7905
Mailing Address - Country:US
Mailing Address - Phone:916-765-2952
Mailing Address - Fax:
Practice Address - Street 1:5795 SAUNDERS AVE
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-7905
Practice Address - Country:US
Practice Address - Phone:916-765-2952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIME SERVICE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-03
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility