Organization
PREMIER COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY G WHYBURN (BUSINESS MANAGER)
(919) 627-2668
Entity
Organization
Contact information
Practice address
4530 S SHERIDAN RD, SUITE 103, TULSA, OK 74145-1141
(918) 627-2668
Mailing address
4530 S SHERIDAN RD, SUITE 103, TULSA, OK 74145-1141
(918) 627-2668
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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