Organization
SUPREME CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. H. GUSTAVO ESTRADA B.A (PRESIDENT)
12013729600
Entity
Organization
Contact information
Practice address
298 RIDGE RD, LYNDHURST, NJ 07071-1929
(201) 372-9600
(201) 372-9550
Mailing address
298 RIDGE RD, LYNDHURST, NJ 07071-1929
(201) 372-9600
(201) 372-9550
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020524
—
NJ
Enumeration date
02/27/2007
Last updated
08/22/2020
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