Provider Demographics
NPI:1780814780
Name:PREMIERE TRANSITIONAL SERVICES, INC.
Entity Type:Organization
Organization Name:PREMIERE TRANSITIONAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJI
Authorized Official - Middle Name:SHAZALE
Authorized Official - Last Name:WILLINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSA
Authorized Official - Phone:678-612-1213
Mailing Address - Street 1:3330 CUMBERLAND BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5995
Mailing Address - Country:US
Mailing Address - Phone:678-612-1212
Mailing Address - Fax:
Practice Address - Street 1:3330 CUMBERLAND BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5995
Practice Address - Country:US
Practice Address - Phone:678-612-1213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency