MEDICARE: PREMIER THERAPY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility	A4142	MD
2	314000000X	Skilled Nursing Facility	A4142	MD

General Provider Information

NPI Number	:	1215301973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER THERAPY SERVICES

Provider Business Mailing Address
First Line	:	3203 UNIVERSITY BLVD W APT 22
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-1817
Country	:	US
Telephone Number	:	240-997-2090
Fax Number	:

Provider Business Practice Location Address
First Line	:	3203 UNIVERSITY BLVD W APT 22
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-1817
Country	:	US
Telephone Number	:	240-997-2090
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. JEAN BROOKS
Credential	:
Telephone Number	:	609-397-7200

Provider Enumeration Date	:	11/18/2015
Last Update Date	:	11/18/2015

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Directions to “PREMIER THERAPY SERVICES ” Practice Location

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