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Organization

PREMIERE BEHAVIORAL SUPPORTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON GIANSANTI (PRESIDENT)
(856) 861-5448
Entity
Organization

Contact information

Practice address
291 GATEWOOD DR, LARGO, FL 33770-2902
(352) 995-8861
(856) 599-8300
Mailing address
404 INDEPENDENCE BLVD, SICKLERVILLE, NJ 08081-1094
(856) 861-5448
(856) 599-8300

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
251S00000X
Community/Behavioral Health Agency
Primary
253Z00000X
In Home Supportive Care Agency
372600000X
Adult Companion
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0588164
NJ
05
114080800
FL
05
115254900
FL
Enumeration date
08/11/2017
Last updated
09/12/2025
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