Healthcare Provider Details

I. General information

NPI: 1942171038
Provider Name (Legal Business Name): OVERCOME DIRECT SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W ELMER RD
VINELAND NJ
08360-6380
US

IV. Provider business mailing address

710 W ELMER RD
VINELAND NJ
08360-6380
US

V. Phone/Fax

Practice location:
  • Phone: 609-428-3701
  • Fax:
Mailing address:
  • Phone: 609-428-3701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA LIDDICK
Title or Position: OWNER
Credential:
Phone: 609-428-3701