Premier Community Supports, LLC.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PREMIER COMMUNITY SUPPORTS, LLC.

Practice address

1439 NE 6TH St Ste C
Grants Pass, OR 97526

Phone

(541) 787-5172

NPI assigned

Aug 2, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Josh Douglas Taylor

Title

Owner

Phone

(541) 787-5172

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1700364502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 NE DEAN DR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262230",
            "telephone_number": "541-787-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 NE 6TH ST STE C",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-787-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER COMMUNITY SUPPORTS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JOSH",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-787-5172",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103120",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pregnancy Care Center of Grants Pass
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• Premier Therapy LLC
• April Lynn Preston
• Matthew Preston
• Kenneth Pricer, RN, BSN
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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oregon

• 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.