Provider Demographics
NPI:1831466986
Name:PREMIER HEALTH SPECIALISTS INC
Entity Type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:PREMIER PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-499-8866
Mailing Address - Street 1:5900 LONG MEADOW DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-9687
Mailing Address - Country:US
Mailing Address - Phone:937-478-0749
Mailing Address - Fax:513-727-2539
Practice Address - Street 1:5900 LONG MEADOW DR
Practice Address - Street 2:SUITE 300
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-9687
Practice Address - Country:US
Practice Address - Phone:937-478-0749
Practice Address - Fax:513-727-2539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH SPECIALISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-17
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9353865Medicare PIN