PREMIERE BEHAVIORAL SUPPORTS (NPI# 1710402631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710402631 |
| Entity Type | Organization |
| Organization Name | PREMIERE BEHAVIORAL SUPPORTS |
| Practice Address |
404 Independence Blvd Sicklerville NJ 08081 |
| Mailing Address |
404 Independence Blvd Sicklerville NJ 08081-1094 |
| Practice Telephone | 8568615448 |
| Practice Fax Number | 8565998300 |
| Mailing Telephone | 8568615448 |
| Mailing Fax Number | 8565998300 |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2019-07-10 |
| Authorized Official Name | JASON GIANSANTI (PRESIDENT) |
| Authorized Official Telephone | 8568615448 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers | ||
| N | 372600000X | Adult Companion | Nursing Service Related Providers | ||
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0588164 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Liberty Pl, Sicklerville, NJ 08081 | 8568615448 | 8565998300 |
| Street Address |
404 INDEPENDENCE BLVD |
| City | SICKLERVILLE |
| State | NJ |
| Zip Code | 08081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113965 | Twonya Williams | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-29 |
| 1144820044 | Jessica Mumford | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-29 |
| 1134729031 | Shermyra Goree | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-29 |
| 1952901852 | Michelle Chandler | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-29 |
| 1245839257 | Jennifer Lukowski | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-21 |
| 1891393633 | Nicole Halty | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-14 |
| 1255938999 | Edith Fuller | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-06 |
| 1790382430 | Destinny Martinez-delgado | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-06 |
| 1891302022 | Tyra Wilson | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-10-01 |
| 1083220180 | Christoph Rein | Counselor | 404 Independence Blvd, Sicklerville, NJ 08081-1094 | 2020-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771031 | Clack Associates, LLC. | Counselor | 603 Liberty Place, Sicklerville, NJ 08081 | 2019-10-13 |
| 1164901351 | Devereux Foundation | Day Training, Developmentally Disabled Services | 1601 - 1603 Sicklerville Road, Sicklerville, NJ 08081 | 2018-08-09 |
| 1467930990 | Brooke Schatzman | Lactation Consultant, Non-RN | 112 Hampton Court, Sicklerville, NJ 08081 | 2018-08-06 |
| 1831686443 | Grandular Senior Living | Day Training/Habilitation Specialist | 542 Berlin Cross Key Road Ste 3-270, Sicklerville, NJ 08081 | 2018-04-18 |
| 1942718465 | Community Dental of Sicklerville, P.C. | Dentist | 513 Cross Keys Road, Sicklerville, NJ 08081 | 2018-01-18 |
| 1831609304 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Brandon Court, Sicklerville, NJ 08081 | 2017-10-10 |
| 1285167346 | A Better Concept | Community/Behavioral Health | 20 Wildcat Branch Dr, Sicklerville, NJ 08081 | 2017-04-06 |
| 1558712299 | Shaquira Briggs | Counselor | 40 Vernon Court, Sicklerville, NJ 08081 | 2016-06-23 |
| 1588012496 | Grace Musokae | Pharmacist | 412 Sicklerville Rd, Jolin's Pharmacy #103, Sicklerville, NJ 08081 | 2016-06-01 |
| 1932553922 | Jenny C Robertson | Counselor | 3111 Route 42 Ste B, Sicklerville, NJ 08081 | 2016-04-16 |
| Find all providers in zip 08081 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114588167 | Starlight Care Companion LLC | In Home Supportive Care | 2 Fir Ct, Sicklerville, NJ 08081-2117 | 2019-06-20 |
| 1053702829 | Your 365 Supportive Coordination Care | In Home Supportive Care | 1 Oak Leaf Ct, Sicklerville, NJ 08081-5285 | 2015-02-13 |
| 1841565017 | Univita | In Home Supportive Care | 14 Rittenhouse Sq, Sicklerville, NJ 08081-4047 | 2012-03-20 |
| 1952692774 | Wch Companion Care | In Home Supportive Care | 2002 Liberty Pl, Suite 703, Sicklerville, NJ 08081-5707 | 2011-04-27 |
| 1073166724 | The Right Support | In Home Supportive Care | 55 Pondview Ln, Sicklerville, NJ 08081-4220 | 2019-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679188 | Long Island Senior Care LLC | In Home Supportive Care | 106 Elm St Apt 2, Orange, NJ 07050-4056 | 2020-11-02 |
| 1285234757 | Inclusive Home Care LLC | In Home Supportive Care | 2 Spinnaker Dr, South Amboy, NJ 08879-3438 | 2020-10-26 |
| 1730788795 | Mario Parker | In Home Supportive Care | 571 Park St, Montclair, NJ 07043-2027 | 2020-10-21 |
| 1588263693 | Fk's&r LLC | In Home Supportive Care | 393 Sanford Ave, Hillside, NJ 07205-2724 | 2020-10-20 |
| 1104424654 | Tnt Ventures, LLC | In Home Supportive Care | 15 Corporate Pl S Ste 405, Piscataway, NJ 08854-6113 | 2020-10-15 |
| 1578161634 | Trontz Enterprises LLC | In Home Supportive Care | 86 River St, Hoboken, NJ 07030-5607 | 2020-10-12 |
| 1538776950 | Sweet Influence Home Care Agency | In Home Supportive Care | 1626 Edmund Ter, Union, NJ 07083-4006 | 2020-09-29 |
| 1184231607 | Wellcare Home Care LLC | In Home Supportive Care | 1281 Valley Rd # B, Wayne, NJ 07470-7980 | 2020-09-29 |
| 1720692932 | Golden Heart Home Care LLC | In Home Supportive Care | 456 Pleasant Valley Way, West Orange, NJ 07052-2921 | 2020-09-04 |
| 1205440690 | Lois Moskowitz | In Home Supportive Care | 9 Camelot Dr, East Brunswick, NJ 08816-3621 | 2020-09-02 |
| Find all providers with the same taxonomy | ||||
| City | SICKLERVILLE |
| Zip Code | 08081 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.