NPIMap

Organization Active NPI

Premier Service of Carolina, Inc

  • Psychiatric Residential Treatment Facility
  • Albemarle, NC
National Provider Identifier
1053637710
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
PREMIER SERVICE OF CAROLINA, INC
Practice address
109 Penny St
Albemarle, NC 28001
Phone
(704) 985-1178
Fax
(704) 985-0106
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Warner Leak
Title
President/Ceo
Phone
(704) 985-1189

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

109 Penny St
Albemarle, NC 28001

Mailing address

109 Penny St
Albemarle, NC 28001-2803
Phone (704) 985-1178

National Provider Directory

National Provider Directory
Tax ID family
Premier Service of Carolina Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1053637710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PENNY ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280012803",
            "telephone_number": "704-985-1178",
            "fax_number": "704-985-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PENNY ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "28001",
            "telephone_number": "704-985-1178",
            "fax_number": "704-985-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SERVICE OF CAROLINA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "LEAK",
        "authorized_official_first_name": "WARNER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "704-985-1189"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.