PREMIUM LIFE CARE, INC., (NPI# 1255578803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255578803 |
| Entity Type | Organization |
| Organization Name | PREMIUM LIFE CARE, INC., |
| Other Organization Name | BRIGHTSTAR CARE OF SAN LUIS OBISPO |
| Practice Address |
3220 S Higuera St Suite 315 San Luis Obispo CA 93401-6987 |
| Practice Telephone | 8055488811 |
| Practice Fax Number | 8052420676 |
| Mailing Telephone | 8055488811 |
| Mailing Fax Number | 8057153460 |
| Enumeration Date | 2009-01-18 |
| Last Update Date | 2020-09-01 |
| Authorized Official Name | MECHELL A VIEIRA (PRESIDENT) |
| Authorized Official Telephone | 8055488811 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE HOME HEALTH AGENCY LICENSE | 550003349 | 01 |
| Other Name | Type Code |
|---|---|
| 247 BrightStar | Doing Business As Name - Organization |
| BrightStar Care of San Luis Obispo | Doing Business As Name - Organization |
| Street Address |
3220 S HIGUERA ST SUITE 315 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-6987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255398871 | Filomena R Rebelo | Psychologist | 3220 S Higuera St, Suite 205, San Luis Obispo, CA 93401-6998 | 2006-04-27 |
| 1821480864 | Shannon Easton-carr, Md, Inc | Psychiatry & Neurology | 3220 S Higuera St, Ste 306, San Luis Obispo, CA 93401-6987 | 2015-02-27 |
| 1083039317 | Monarch Home Care Inc. | Technician | 3220 S Higuera St, Suite 225, San Luis Obispo, CA 93401-6987 | 2014-02-24 |
| 1710227889 | Suzanne Mary Barron | Marriage & Family Therapist | 3220 S Higuera St, Suite 306, San Luis Obispo, CA 93401-6987 | 2013-02-26 |
| 1770858755 | Peaceful Mind, Inc. | Behavioral Analyst | 3220 S Higuera St, Ste 205, San Luis Obispo, CA 93401-6987 | 2012-03-09 |
| 1508091711 | Shannon Easton-carr | Psychiatry & Neurology | 3220 S Higuera St, Suite 306, San Luis Obispo, CA 93401-6987 | 2009-05-18 |
| 1164615910 | Pacific Psychiatry Inc. | Psychiatry & Neurology | 3220 S Higuera St, Suite 215, San Luis Obispo, CA 93401-6987 | 2007-08-24 |
| 1821117813 | Martin Cosgro | Psychologist | 3220 S Higuera St, Ste. 220, San Luis Obispo, CA 93401-6987 | 2007-03-29 |
| 1861557571 | Joseph Edward Holifield | Psychologist | 3220 S Higuera St, Suite 306, San Luis Obispo, CA 93401-6987 | 2006-12-22 |
| 1871523019 | Abdellatif A. Aichouri | Psychiatry & Neurology | 3220 S Higuera St, Suite 205, San Luis Obispo, CA 93401-6998 | 2006-07-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629614029 | Guardian Angel Home Care of San Luis Obispo | Home Health | 1428 Phillips Ln Ste B2, San Luis Obispo, CA 93401-2571 | 2019-11-20 |
| 1518194505 | Amedisys California LLC | Home Health | 4051 Broad St, Suite 126, San Luis Obispo, CA 93401-8714 | 2009-06-17 |
| 1326086786 | Maxim Healthcare Services, Inc. | Home Health | 735 Tank Farm Rd Ste 135, San Luis Obispo, CA 93401 | 2006-06-04 |
| 1154397966 | Crescent Healthcare, Inc. | Home Health | 2995 Mcmillan Ave, Suite 196, San Luis Obispo, CA 93401-6769 | 2006-02-23 |
| 1235137738 | Wilshire Health and Community Services, Inc. | Home Health | 277 South St, Suite W, San Luis Obispo, CA 93401-5039 | 2005-07-08 |
| 1942605076 | Guardian Angel Home Care, Inc. | Home Health | 1428 Phillips Ln, Suite B-2, San Luis Obispo, CA 93401-2537 | 2014-10-31 |
| 1861428567 | Gentiva Certified Healthcare Corp. | Home Health | 3220 S Higuera St, Suite 101, San Luis Obispo, CA 93401-6983 | 2006-06-24 |
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| 1588265441 | Tender Home Health | Home Health | 17031 Chatsworth St Ste 201, Granada Hills, CA 91344-5883 | 2020-11-05 |
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| 1467053579 | Renewed Home Health, Inc. | Home Health | 1965 Yosemite Drive #110, Simi Valley, CA 93063 | 2020-11-04 |
| 1184225203 | Burbank City Home Health, Inc | Home Health | 2000 W Magnolia Blvd Ste 205, Burbank, CA 91506-1707 | 2020-11-04 |
| 1851992267 | Galaxy Home Health | Home Health | 13647 Vanowen St Ste C, Van Nuys, CA 91405-4262 | 2020-11-03 |
| 1053912436 | Adonai Home Health Care | Home Health | 1010 N Central Ave # 410, Glendale, CA 91202-2937 | 2020-11-03 |
| Find all providers with the same taxonomy | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.