Organization
PREMIER SUPPORTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
2 CRANSTON RD, KENDALL PARK, NJ 08824-1116
(512) 327-2325
(512) 628-1553
Mailing address
6600 FRANCE AVE S STE 350, EDINA, MN 55435-1810
(800) 388-5150
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
11/06/2024
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