NPIMap

Organization Active NPI

Premier Harmony Place LLC

Doing business as Positive Reset Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, NJ
National Provider Identifier
1326875774
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PREMIER HARMONY PLACE LLC
Doing business as
Positive Reset Services
Practice address
10 Mountain Blvd Ste C
Warren, NJ 07059-2639
Phone
(732) 742-0349
NPI assigned
Sep 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Oksana Borodynkina
Title
President
Phone
(732) 742-0349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

10 Mountain Blvd Ste C
Warren, NJ 07059-2639

Mailing address

84 Lone Star LN
Manalapan, NJ 07726-3878
Phone (732) 742-0349

Other names 1

  • POSITIVE RESET SERVICES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250407002226 NJ Part B Supplier - Clinic/Group Practice 9638693195 Receives reassigned benefits from 6 practitioners
Practice locations: Warren, NJ

National Provider Directory

National Provider Directory

Locations

10 Mountain Blvd
Ste C
Warren, NJ 07059
Phone (732) 742-0349

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1326875774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 LONE STAR LN",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263878",
            "telephone_number": "732-742-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MOUNTAIN BLVD STE C",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070592639",
            "telephone_number": "732-742-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HARMONY PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "BORODYNKINA",
        "authorized_official_first_name": "OKSANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-742-0349"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POSITIVE RESET SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.