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General NPI Number Information
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NPI Number | 1508672403
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Entity Type | Organization
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Legal Business Name | PREMIER COMMUNITY HEALTH
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 3170 KETTERING BLVD
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City | MORAINE
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State | OH
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Zip | 45439-1924
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Country | US
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Telephone | 937-208-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 3170 KETTERING BLVD
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City | MORAINE
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State | OH
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Zip | 45439-1924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR OPERATIONS
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Name | SANDRA HAIG
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Credential |
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Telephone | 937-208-6495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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