Healthcare Provider Details

I. General information

NPI: 1962310748
Provider Name (Legal Business Name): PREMIER SUPPORT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9911 JEFFERSON AVE
NEWPORT NEWS VA
23605-1163
US

IV. Provider business mailing address

324 WILLIAMSBURG CT
NEWPORT NEWS VA
23606-1622
US

V. Phone/Fax

Practice location:
  • Phone: 757-218-2640
  • Fax:
Mailing address:
  • Phone: 757-218-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. JOHNIENE MICHELLE MILLER
Title or Position: CEO
Credential:
Phone: 757-218-2640