Provider Demographics
NPI:1427245158
Name:PREMIUM HEALTHCARE SERVICES, INC
Entity type:Organization
Organization Name:PREMIUM HEALTHCARE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHIGBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-254-9770
Mailing Address - Street 1:16500 CHEF MENTEUR HWY
Mailing Address - Street 2:SUITE
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129
Mailing Address - Country:US
Mailing Address - Phone:504-254-9770
Mailing Address - Fax:504-254-8088
Practice Address - Street 1:16500 CHEF MENTEUR HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129
Practice Address - Country:US
Practice Address - Phone:504-254-9770
Practice Address - Fax:504-254-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)