Personalized Support Services LTD Liability Co.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PERSONALIZED SUPPORT SERVICES LTD LIABILITY CO.

Practice address

40 Edge Hill Rd
Blairstown, NJ 07825-9788

Phone

(908) 414-7510

NPI assigned

Feb 14, 2018

Last updated

Jun 10, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terri McGowan, BA

Title

Owner

Phone

(908) 414-7510

Specialties & licenses 9

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1215437421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 263",
            "city": "BLAIRSTOWN",
            "state": "NJ",
            "postal_code": "078250263",
            "telephone_number": "908-343-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EDGE HILL RD",
            "city": "BLAIRSTOWN",
            "state": "NJ",
            "postal_code": "078259788",
            "telephone_number": "908-414-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED SUPPORT SERVICES LTD LIABILITY CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "MCGOWAN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-414-7510",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.