Organization
PREMIER PERSONAL HEALTH SERVICES, LLC
Active
Other names
PREMIER CLA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA YVONNE BRADSHAW-SMALL APRN-BC (CEO)
(404) 819-9665
Entity
Organization
Contact information
Practice address
8025 WILKERSON LN, PALMETTO, GA 30268-8626
(404) 819-9665
(678) 624-6030
Mailing address
6269 GREENOCK DR, STONE MOUNTAIN, GA 30087-6081
(404) 819-9665
(866) 624-6594
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112727A
—
GA
Enumeration date
03/04/2012
Last updated
08/12/2012
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