Provider Demographics
NPI:1912868654
Name:PREMIER3 STEM FOUNDATION INC
Entity type:Organization
Organization Name:PREMIER3 STEM FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-923-3457
Mailing Address - Street 1:10364 1/2 MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:WEST FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:62896-4868
Mailing Address - Country:US
Mailing Address - Phone:618-218-5852
Mailing Address - Fax:618-615-4578
Practice Address - Street 1:10364 1/2 MITCHELL ST
Practice Address - Street 2:
Practice Address - City:WEST FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:62896-4868
Practice Address - Country:US
Practice Address - Phone:224-966-8051
Practice Address - Fax:618-615-4578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-21
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health