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Organization

PREMIUM COMMUNITY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH JAKAUS (OWNER)
(617) 669-0444
Entity
Organization

Contact information

Practice address
1354 HANCOCK ST STE 208, QUINCY, MA 02169-5109
(617) 669-0444
Mailing address
1354 HANCOCK ST STE 208, QUINCY, MA 02169-5109
(617) 669-0444

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/08/2025
Last updated
09/08/2025
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