OrganizationActive
Premier Medical Group, LLC
NPI 1104649946 · Substance Use Disorder Rehabilitation Clinic/Center · Bloomington, IN
Provider details
- NPI number
- 1104649946
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kirill Vesselov, Manager(561) 556-3721
Specialties & taxonomies
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Practice location
409 W 1st St
Bloomington, IN 47403-2403
Phone: (561) 556-3721
Approximate (ZIP-level) locationGet directions
Mailing address
2925 10th Ave N
Palm Springs, FL 33461-3000
Registry dates
- Enumerated
- 2024-10-31
- Last updated
- 2024-12-06
- Certified
- 2024-12-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.