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Organization
PREMIER CARE OF OHIO, LLC
Active
Organization
PREMIER CARE OF OHIO, LLC
Active
Other names
CMS ELYRIA
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRA VILCHIS (CREDENTIALING PROVIDER DATA MANAGER)
(480) 977-1438
Entity
Organization
Contact information
Practice address
1508 W RIVER RD N, ELYRIA, OH 44035-2714
(601) 248-8886
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
(602) 854-0504
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/21/2024
Last updated
05/22/2024
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