Provider Demographics
NPI:1316654486
Name:PERSON CENTERED HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PERSON CENTERED HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIXON
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOO
Authorized Official - Suffix:
Authorized Official - Credentials:APN-BC
Authorized Official - Phone:929-481-5451
Mailing Address - Street 1:1199 AMBOY AVE STE 304-F5
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2552
Mailing Address - Country:US
Mailing Address - Phone:929-481-5451
Mailing Address - Fax:929-512-5519
Practice Address - Street 1:1199 AMBOY AVE STE 304-F5
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2552
Practice Address - Country:US
Practice Address - Phone:929-481-5451
Practice Address - Fax:929-512-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty