Organization
PREMIER SERVICE OF CAROLINA, INC
Active
Organization
PREMIER SERVICE OF CAROLINA, INC
Active
Parent organization
PREMIER SERVICE OF CAROLINA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER SERVICE OF CAROLINA, INC.
Authorized official
CLARENCE LAWING (PROGRAM DIRECTOR)
(704) 985-1189
Entity
Organization
Contact information
Practice address
207 N BOONE ST STE 300, JOHNSON CITY, TN 37604-5675
(704) 985-1189
(704) 985-1189
Mailing address
109 PENNY ST, ALBEMARLE, NC 28001-2803
(704) 985-1189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
I000000019328
TN
251S00000X
Community/Behavioral Health Agency
Primary
I000000021371
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q021696
—
TN
Enumeration date
01/06/2017
Last updated
03/14/2018
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