MEDICARE: QUALITY FIRST SUPPORT GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1104603885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY FIRST SUPPORT GROUP, LLC

Provider Business Mailing Address
First Line	:	1099 WHITE HORSE RD FL 2
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4405
Country	:	US
Telephone Number	:	856-521-9095
Fax Number	:	609-543-2413

Provider Business Practice Location Address
First Line	:	1099 WHITE HORSE RD FL 2
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4405
Country	:	US
Telephone Number	:	856-521-9095
Fax Number	:	609-543-2413

Authorized Official
Title or Position	:	CEO
Name	:	GEORGIE DIEM NGUYEN
Credential	:
Telephone Number	:	856-521-9095

Provider Enumeration Date	:	09/14/2023
Last Update Date	:	05/28/2025

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