Provider Demographics
NPI:1801210737
Name:PREMIER BUSINESS DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:PREMIER BUSINESS DEVELOPMENT CORPORATION
Other - Org Name:SERENITY PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-477-9866
Mailing Address - Street 1:PO BOX 737
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-0737
Mailing Address - Country:US
Mailing Address - Phone:205-477-9866
Mailing Address - Fax:888-769-3109
Practice Address - Street 1:6424 OLD TUSCALOOSA HIGHWAY
Practice Address - Street 2:
Practice Address - City:MCCALLA
Practice Address - State:AL
Practice Address - Zip Code:35111-0737
Practice Address - Country:US
Practice Address - Phone:205-477-9866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty