Provider Demographics
NPI:1114599305
Name:PREMIER MENTAL & BEHAVIORAL SERVICES, INC
Entity Type:Organization
Organization Name:PREMIER MENTAL & BEHAVIORAL SERVICES, INC
Other - Org Name:POSITIVE RESET SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-735-4256
Mailing Address - Street 1:615 HOPE RD STE 3B
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1273
Mailing Address - Country:US
Mailing Address - Phone:732-724-1234
Mailing Address - Fax:732-532-0801
Practice Address - Street 1:615 HOPE RD STE 3B
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1273
Practice Address - Country:US
Practice Address - Phone:732-735-4256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450362584OtherMEDICARE, COMMERCIAL INSURANCES
NJ0450362584Medicaid