NPIMap

Organization Active NPI

Premier Service of Carolina, Inc

  • Community/Behavioral Health Agency
  • Kings Mountain, NC
National Provider Identifier
1467082396
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PREMIER SERVICE OF CAROLINA, INC
Practice address
510 W King St
Kings Mountain, NC 28086-3310
Phone
(704) 750-4222
NPI assigned
Jan 20, 2020
Organization subpart
Yes
Parent organization
PREMIER SERVICE OF CAROLINA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Warner Leak
Title
Owner, Ceo
Phone
(704) 985-1189

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

510 W King St
Kings Mountain, NC 28086-3310

Mailing address

929 Concord Pkwy S Ste K
Concord, NC 28027-5031
Phone (704) 985-1189

Other practice location 1

929 Concord Pkwy S Ste K
Concord, NC 28027-5031
Phone (704) 985-1189

National Provider Directory

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

Other organizations with this tax ID 4

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

Locations

2020 Remount Rd
Ste 105
Gastonia, NC 28054

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1467082396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 CONCORD PKWY S STE K",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280275031",
            "telephone_number": "704-985-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W KING ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863310",
            "telephone_number": "704-750-4222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Concord Pkwy S Ste K",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280275031",
            "country_code": "US",
            "telephone_number": "704-985-1189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER SERVICE OF CAROLINA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER SERVICE OF CAROLINA, INC",
        "enumeration_date": "2020-01-20",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "LEAK",
        "authorized_official_first_name": "WARNER",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "704-985-1189"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.