Provider Demographics
NPI:1407537673
Name:PREMIER SUPPORT COMMUNITY SERVICES CORPORATION
Entity Type:Organization
Organization Name:PREMIER SUPPORT COMMUNITY SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:856-297-6726
Mailing Address - Street 1:117 TARA RUN
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3049
Mailing Address - Country:US
Mailing Address - Phone:856-297-6726
Mailing Address - Fax:
Practice Address - Street 1:117 TARA RUN
Practice Address - Street 2:
Practice Address - City:WOOLWICH TWP
Practice Address - State:NJ
Practice Address - Zip Code:08085-3049
Practice Address - Country:US
Practice Address - Phone:856-297-6726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care