PREMIER COMMUNITY SUPPORTS, LLC. (NPI# 1700364502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700364502 |
| Entity Type | Organization |
| Organization Name | PREMIER COMMUNITY SUPPORTS, LLC. |
| Practice Address |
1439 Ne 6th St Ste C Grants Pass OR 97526 |
| Mailing Address |
521 Ne Dean Dr Grants Pass OR 97526-2230 |
| Practice Telephone | 5417875172 |
| Mailing Telephone | 5417875172 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-14 |
| Authorized Official Name | MR. JOSH DOUGLAS TAYLOR (OWNER) |
| Authorized Official Telephone | 5417875172 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 103120 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PREMIER COMMUNITY SUPPORTS, LLC. | 1215 Ne 7th Street Suite F, Grants Pass, OR 97526 |
| Street Address |
1439 NE 6TH ST STE C |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| 1871968602 | Jeffrey A Christophersen | Counselor | 109 Nw Manzanita Ave, Grants Pass, OR 97526 | 2015-12-04 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907960 | Tandem Northwest, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 348 Dennis Ln N, Keizer, OR 97303-5936 | 2020-06-23 |
| 1184240558 | Community Access Services II, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1815 Nw 169th Pl Ste 1060, Beaverton, OR 97006-7365 | 2020-06-22 |
| 1134619752 | Asd Stepping Stones To Success | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 91145 N Willamette St Ste 8211, Coburg, OR 97408-9700 | 2018-05-18 |
| 1669864724 | Visions LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 E Broadway Ste 100, Eugene, OR 97401-3175 | 2015-02-26 |
| 1417375270 | Educational Training Program Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15420 Forsythe Rd, Oregon City, OR 97045-8742 | 2014-03-30 |
| 1023356391 | Trust Home Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10706 Sw Capitol Hwy Apt 58, Portland, OR 97219-6880 | 2013-01-22 |
| 1255678157 | Renew Consulting, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1555 Post St, Lebanon, OR 97355-4060 | 2013-01-11 |
| 1881931798 | Renew Consulting, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3415 Columbia View Dr, The Dalles, OR 97058-9703 | 2013-01-11 |
| 1255676078 | Renew Consulting, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8129 Sw 168th Ave, Beaverton, OR 97007-6504 | 2012-12-05 |
| 1285978569 | Renew Consulting, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 704 38th Ave Se, Albany, OR 97322-3807 | 2012-11-27 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.