Provider Demographics
NPI:1669038295
Name:PREMIER SUPPORTS, LLC
Entity Type:Organization
Organization Name:PREMIER SUPPORTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:800-388-5150
Mailing Address - Street 1:313 CONGRESS ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1218
Mailing Address - Country:US
Mailing Address - Phone:800-388-5150
Mailing Address - Fax:617-790-4271
Practice Address - Street 1:2 CRANSTON RD
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1116
Practice Address - Country:US
Practice Address - Phone:512-327-2325
Practice Address - Fax:512-628-1553
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D&S RESIDENTIAL HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-20
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities