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Organization
P.R.I.M.E EXECUTIVE HOLDING GROUP LLC
Active
Organization
P.R.I.M.E EXECUTIVE HOLDING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINA POUGH MA (COMPLIANCE & QUALITY DIRECTOR)
(307) 285-0360
Entity
Organization
Contact information
Practice address
309 MUNICIPAL DR, THORNDALE, PA 19372-1023
(307) 285-0358
(307) 285-0358
Mailing address
30 N GOULD ST # 65891, SHERIDAN, WY 82801-6317
(307) 285-0358
(307) 285-0358
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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