Provider Demographics
NPI:1760292700
Name:PREMIUM SERVICES, INC
Entity type:Organization
Organization Name:PREMIUM SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:CHIE
Authorized Official - Last Name:NGATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-919-3797
Mailing Address - Street 1:616 POTOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3838
Mailing Address - Country:US
Mailing Address - Phone:301-919-3792
Mailing Address - Fax:
Practice Address - Street 1:616 POTOMAC AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3838
Practice Address - Country:US
Practice Address - Phone:301-919-3792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services