NPIMap

Organization Active NPI

Premier Service of Carolina, Inc

  • Community/Behavioral Health Agency
  • Concord, NC
National Provider Identifier
1710651872
Registry record updated Apr 7, 2023
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
929 Concord Pkwy S Ste K
Concord, NC 28027-5031
Phone
(704) 985-1189
NPI assigned
Aug 3, 2021
Last updated
Apr 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

929 Concord Pkwy S Ste K
Concord, NC 28027-5031

Mailing address

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

Other names 1

  • Premier Service of Carolina Inc Other name

National Provider Directory

National Provider Directory
Tax ID family
Premier Service of Carolina Inc5 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.

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1710651872",
    "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": "929 CONCORD PKWY S STE K",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280275031",
            "telephone_number": "704-985-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SERVICE OF CAROLINA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "LEAK",
        "authorized_official_first_name": "WARNER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-985-1189"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Service of Carolina Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Premier Service of Carolina Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.