Provider Demographics
NPI:1528433190
Name:PREMIER AGE CARE CORP
Entity type:Organization
Organization Name:PREMIER AGE CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:STURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-459-3312
Mailing Address - Street 1:1115 W PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-7624
Mailing Address - Country:US
Mailing Address - Phone:817-459-3312
Mailing Address - Fax:817-459-3314
Practice Address - Street 1:1115 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-7624
Practice Address - Country:US
Practice Address - Phone:817-459-3312
Practice Address - Fax:817-459-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care