| Premiere Behavioral Supports | |
|
291 Gatewood Dr Largo FL 33770-2902 | |
| (352) 995-8861 | |
| (856) 599-8300 |
| Full Name | Premiere Behavioral Supports |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 291 Gatewood Dr, Largo, Florida |
| Authorized Official Name and Position | Jason Giansanti (PRESIDENT) |
| Authorized Official Contact | 8568615448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiere Behavioral Supports 404 Independence Blvd Sicklerville NJ 08081-1094 Ph: (856) 861-5448 | Premiere Behavioral Supports 291 Gatewood Dr Largo FL 33770-2902 Ph: (352) 995-8861 |
| NPI Number | 1710402631 |
|---|---|
| Provider Enumeration Date | 08/11/2017 |
| Last Update Date | 09/15/2022 |
| Certification Date | 09/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710402631 | NPI | - | NPPES |
| 0588164 | Medicaid | NJ | |
| 114080800 | Medicaid | FL | |
| 115254900 | Medicaid | FL |
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