Healthcare Provider Details

I. General information

NPI: 1053220988
Provider Name (Legal Business Name): ENCORE EDUCATIONAL INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 ORLANDO DR
SICKLERVILLE NJ
08081-4492
US

IV. Provider business mailing address

71 ORLANDO DR
SICKLERVILLE NJ
08081-4492
US

V. Phone/Fax

Practice location:
  • Phone: 609-455-9285
  • Fax: 856-740-1003
Mailing address:
  • Phone: 609-455-9285
  • Fax: 856-740-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL WILLIAM MIMMS
Title or Position: DIRECTOR/CONSULTANT
Credential: ED.D.
Phone: 609-455-9285