Provider Demographics
NPI:1700510740
Name:PREMIER MENTAL HEALTH SERVICES PLC
Entity Type:Organization
Organization Name:PREMIER MENTAL HEALTH SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JARRYD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:815-429-7739
Mailing Address - Street 1:1676 BROOKDALE RD APT 23
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-0411
Mailing Address - Country:US
Mailing Address - Phone:815-429-7739
Mailing Address - Fax:
Practice Address - Street 1:137 BLUFF ST RM 1
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7651
Practice Address - Country:US
Practice Address - Phone:815-429-7739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty