Provider Demographics
NPI:1467822288
Name:PREMIER TREATMENT SPECIALISTS, LLC.
Entity Type:Organization
Organization Name:PREMIER TREATMENT SPECIALISTS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MACE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:864-553-3154
Mailing Address - Street 1:400 BEVERLY HANKS CTR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2303
Mailing Address - Country:US
Mailing Address - Phone:864-553-3154
Mailing Address - Fax:828-595-9598
Practice Address - Street 1:400 BEVERLY HANKS CTR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2303
Practice Address - Country:US
Practice Address - Phone:864-553-3154
Practice Address - Fax:828-595-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL-045-122261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty