Provider Demographics
NPI:1316254543
Name:PREMIER LIVE-INS, INC.
Entity type:Organization
Organization Name:PREMIER LIVE-INS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURCHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MPA
Authorized Official - Phone:914-428-7722
Mailing Address - Street 1:445 HAMILTON AVE
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1807
Mailing Address - Country:US
Mailing Address - Phone:914-428-7722
Mailing Address - Fax:914-428-2404
Practice Address - Street 1:300 W MAIN ST
Practice Address - Street 2:BLDG. A, SUITE 5
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2132
Practice Address - Country:US
Practice Address - Phone:508-393-8570
Practice Address - Fax:508-393-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7246163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7245OtherLICENSE TO ESTABLISH AND CONDUCT AN EMPLOYMENT AGENCY
MA7247OtherLICENSE TO ESTABLISH AND CONDUCT AN EMPLOYMENT AGENCY
MA7246OtherLICENSE TO ESTABLISH AND CONDUCT AN EMPLOYMENT AGENCY