Organization
PREMIER COMMUNITY SUPPORTS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSH DOUGLAS TAYLOR (OWNER)
(541) 787-5172
Entity
Organization
Contact information
Practice address
1439 NE 6TH ST STE C, GRANTS PASS, OR 97526
(541) 787-5172
Mailing address
521 NE DEAN DR, GRANTS PASS, OR 97526-2230
(541) 787-5172
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103120
—
OR
Enumeration date
08/02/2018
Last updated
08/14/2018
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