Organization
PREMIER COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA COLLINS LCSW (EXECUTIVE DIRECTOR)
(225) 405-3333
Entity
Organization
Contact information
Practice address
3414 MOSS ST, STE C, LAFAYETTE, LA 70507-6107
(337) 269-8990
(225) 272-1940
Mailing address
3414 MOSS ST, STE C, LAFAYETTE, LA 70507-6107
(337) 269-8990
(225) 272-1940
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
PCA15118
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1329215
—
LA
Enumeration date
03/16/2009
Last updated
03/16/2009
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