Organization Active NPI

Premier Group LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Madison, AL
National Provider Identifier
1376375279
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
PREMIER GROUP LLC
Practice address
244 Kyser Blvd Apt 503
Madison, AL 35758-3120
Phone
(256) 957-2100
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Tomiko Evatte SmileyNPI 1629755673
Title
Owner/Ceo
Phone
(256) 957-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

244 Kyser Blvd Apt 503
Madison, AL 35758-3120

Mailing address

2105 Queenston Loop SW
Decatur, AL 35603-7705
Phone (256) 957-2100

Other names 1

  • Premier Group Home Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1376375279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 QUEENSTON LOOP SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356037705",
            "telephone_number": "256-957-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 KYSER BLVD APT 503",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583120",
            "telephone_number": "256-957-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "TOMIKO",
        "authorized_official_middle_name": "EVATTE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "256-957-2100"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.