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Organization

PREMIER THERAPY SERVICES

Active
Parent organization
REVERA INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
REVERA INC.
Authorized official
ISAO KITAGUCHI OTR (OCCUPATIONAL THERAPIST)
(201) 681-2581
Entity
Organization

Contact information

Practice address
5 BOROLINE RD, SADDLE RIVER, NJ 07458-2343
(201) 818-8680
Mailing address
5 BOROLINE RD, SADDLE RIVER, NJ 07458-2343
(201) 818-8680

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
46TR00669800
NJ

Other

Enumeration date
04/01/2015
Last updated
04/01/2015
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