| Supreme Consultants Llc | |
|
298 Ridge Rd Lyndhurst NJ 07071-1929 | |
| (201) 372-9600 | |
| (201) 372-9550 |
| Full Name | Supreme Consultants Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 298 Ridge Rd, Lyndhurst, New Jersey |
| Authorized Official Name and Position | H. Gustavo Estrada (PRESIDENT) |
| Authorized Official Contact | 12013729600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supreme Consultants Llc 298 Ridge Rd Lyndhurst NJ 07071-1929 Ph: (201) 372-9600 | Supreme Consultants Llc 298 Ridge Rd Lyndhurst NJ 07071-1929 Ph: (201) 372-9600 |
| NPI Number | 1235266396 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235266396 | NPI | - | NPPES |
| 0020524 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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