Premier Care of Ohio, LLC

NPI #1437915055 in Elyria, Ohio

Provider Information

NPI Number: 1437915055
Entity Type: Organization
Organization Name: Premier Care of Ohio, LLC
Primary Specialty: Clinic/Center - Methadone
Enumeration Date: Feb 21, 2024
Last Updated: May 22, 2024

Practice Location

Address: 1508 W RIVER RD N
City: Elyria
State: Ohio
ZIP Code: 44035-2714
Phone: (601) 248-8886

Authorized Official

Name: ALEJANDRA VILCHIS
Title: CREDENTIALING PROVIDER DATA MANAGER
Phone: (480) 977-1438

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Community/Behavioral Health	251S00000X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Methadone — Methadone	261QM2800X	Primary

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