Provider Demographics
NPI:1770101545
Name:NORTHWEST PREMIER LLC
Entity type:Organization
Organization Name:NORTHWEST PREMIER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TORRONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-321-2213
Mailing Address - Street 1:954 ALDRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-6594
Mailing Address - Country:US
Mailing Address - Phone:541-321-2213
Mailing Address - Fax:
Practice Address - Street 1:560 W ROSE ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2624
Practice Address - Country:US
Practice Address - Phone:541-321-2213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness