| Premier Consulting Toledo Llc | |
|
701 Jefferson Ave Ste 203 Toledo OH 43604-6957 | |
| (707) 391-1752 | |
| Not Available |
| Full Name | Premier Consulting Toledo Llc |
|---|---|
| Speciality | Social Worker |
| Location | 701 Jefferson Ave Ste 203, Toledo, Ohio |
| Authorized Official Name and Position | Shay Elletha Bankston (OWNER) |
| Authorized Official Contact | 7073911752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Consulting Toledo Llc 2308 Robinwood Ave Apt 1 Toledo OH 43620-1024 Ph: () - | Premier Consulting Toledo Llc 701 Jefferson Ave Ste 203 Toledo OH 43604-6957 Ph: (707) 391-1752 |
| NPI Number | 1659077121 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 02/06/2023 |
| Certification Date | 02/06/2023 |
| Medicare PECOS PAC ID | 0446615462 |
|---|---|
| Medicare Enrollment ID | O20230426003085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659077121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shay Elletha Bankston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821462367 PECOS PAC ID: 7214214691 Enrollment ID: I20230426003119 |
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