Premier Community Living
NPI #1699824318 in Wake Village, Texas
Provider Information
- NPI Number
- 1699824318
- Entity Type
- Organization
- Organization Name
- Premier Community Living
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jan 10, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1013 MARIANA DR
- City
- Wake Village
- State
- Texas
- ZIP Code
- 75501-6212
- Phone
- (903) 832-2975
Authorized Official
- Name
- MRS. TARA LYNN JACKSON
- Title
- MEMBERMANAGER
- Phone
- (817) 987-2649
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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