NPIMap

Organization Active NPI

Premier Behavioral Services Inc

  • Community/Behavioral Health Agency
  • Lumberton, NC
National Provider Identifier
1689719296
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PREMIER BEHAVIORAL SERVICES INC
Practice address
2003 Godwin Ave Ste B
Lumberton, NC 28358-3197
Phone
(910) 671-1111
Fax
(910) 671-4454
NPI assigned
Feb 21, 2007
Organization subpart
Yes
Parent organization
PREMIER BEHAVIORAL SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Santhosh Augustine
Title
Owner
Phone
(910) 733-2007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2003 Godwin Ave Ste B
Lumberton, NC 28358-3197

Mailing address

2003 Godwin Ave Ste B
Lumberton, NC 28358-3197
Phone (910) 671-1111

Other identifiers 5

IdentifierTypeStateIssuer
3408672MedicaidNC
8300573GMedicaidNC
6006152MedicaidNC
8300573HMedicaidNC
8300573BMedicaidNC

Other names 1

  • Premier Behavioral Services Inc Other name

National Provider Directory

National Provider Directory
Tax ID family
Premier Behavioral Services Inc3 organizations share this tax ID, including this one
Part of
Premier Behavioral Services Inc

Other organizations with this tax ID 2

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

Locations

2003 Godwin Ave
Ste B
Lumberton, NC 28358
Phone (910) 316-9230

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1689719296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVE STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583197",
            "telephone_number": "910-671-1111",
            "fax_number": "910-671-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVE STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583197",
            "telephone_number": "910-671-1111",
            "fax_number": "910-671-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER BEHAVIORAL SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER BEHAVIORAL SERVICES INC",
        "enumeration_date": "2007-02-21",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "SANTHOSH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-733-2007"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408672",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300573G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006152",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300573H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300573B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Behavioral Services Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.