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General NPI Number Information
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NPI Number | 1912705484
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Entity Type | Organization
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Legal Business Name | PREMIER PSYCHIATRIC PROVIDERS CORPORATION
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 935 N. BENEVA ROAD STE 609
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City | SARASOTA
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State | FL
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Zip | 34232
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Country | US
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Telephone | 941-999-0559
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Fax | 833-227-3180
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Provider Business Mailing Address
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Address Line | 20 MEADOWBROOK LN
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City | PALMER
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State | MA
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Zip | 01069-1134
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Country | US
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Telephone | 941-999-0559
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Fax | 833-227-3180
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL EVAN MANN
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Credential |
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Telephone | 941-999-0559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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