Provider Demographics
NPI:1528769288
Name:PRIORITY HOME CARE CENTER LLC
Entity type:Organization
Organization Name:PRIORITY HOME CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARQADLE
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:614-707-3049
Mailing Address - Street 1:5950 MAYFIELD RD STE 1161
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2905
Mailing Address - Country:US
Mailing Address - Phone:614-707-3049
Mailing Address - Fax:
Practice Address - Street 1:11811 SHAKER BLVD STE 310
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1955
Practice Address - Country:US
Practice Address - Phone:614-707-3049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health