Provider Demographics
NPI:1932605714
Name:PRIORITY HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:PRIORITY HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN-RN
Authorized Official - Phone:314-495-5503
Mailing Address - Street 1:1310 SPRING LILLY DR
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-1184
Mailing Address - Country:US
Mailing Address - Phone:314-495-5503
Mailing Address - Fax:314-428-0151
Practice Address - Street 1:1310 SPRING LILLY DR
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-1184
Practice Address - Country:US
Practice Address - Phone:314-495-5503
Practice Address - Fax:314-428-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health