Healthcare Provider Details

I. General information

NPI: 1588934004
Provider Name (Legal Business Name): PREMIER COUNSELING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2012
Last Update Date: 01/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HASKELL AVE SUITE 2
HASKELL NJ
07420-1511
US

IV. Provider business mailing address

PO BOX 9150
PARAMUS NJ
07653-9150
US

V. Phone/Fax

Practice location:
  • Phone: 862-242-6778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. LABINOT ALEXANDER BERLAJOLLI
Title or Position: CEO
Credential: ESQ.
Phone: 862-242-6778