Provider Demographics
NPI:1760368559
Name:SUPREME CONSULTANTS, LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:SUPREME CONSULTANTS, LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HERNOLDE
Authorized Official - Middle Name:GUSTAVO
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-372-9600
Mailing Address - Street 1:71 UNION AVENUE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-372-9600
Mailing Address - Fax:201-372-9550
Practice Address - Street 1:71 UNION AVENUE
Practice Address - Street 2:SUITE 207
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-372-9600
Practice Address - Fax:201-372-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health