Provider Demographics
NPI:1932521309
Name:PREMIER HEALTHCARE STAFFING LLC
Entity Type:Organization
Organization Name:PREMIER HEALTHCARE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:973-857-0100
Mailing Address - Street 1:11 LONG BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4947
Mailing Address - Country:US
Mailing Address - Phone:973-857-0100
Mailing Address - Fax:973-857-0108
Practice Address - Street 1:25 POMPTON AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2941
Practice Address - Country:US
Practice Address - Phone:973-857-0100
Practice Address - Fax:973-857-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0181200252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency