NPIMap

Organization Active NPI

Premier Health Care, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Clinton, MD
National Provider Identifier
1417435686
Registry record updated Jan 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
PREMIER HEALTH CARE, LLC
Practice address
12003 Piscataway Rd
Clinton, MD 20735-1168
Phone
(240) 396-5873
NPI assigned
Jul 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2019

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

Authorized official

Name
Gwendolyn Lindsey
Title
Program Manager
Phone
(301) 979-8300

Specialties & licenses 1

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

Addresses

Primary practice location

12003 Piscataway Rd
Clinton, MD 20735-1168

Mailing address

12003 Piscataway Rd
Clinton, MD 20735-1168
Phone (240) 396-5873

National Provider Directory

National Provider Directory
Tax ID family
Premier Health Care LLC5 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": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547942400000",
    "number": "1417435686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12003 PISCATAWAY RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351168",
            "telephone_number": "240-396-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12003 PISCATAWAY RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351168",
            "telephone_number": "240-396-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2019-01-20",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "301-979-8300"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2019; 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.