Healthcare Provider Details

I. General information

NPI: 1437071537
Provider Name (Legal Business Name): PRESTIGE PERSONAL CARE SERVICES OF GEORGIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 BROAD ST STE 108 1ST FLOOR
AUGUSTA GA
30901-1214
US

IV. Provider business mailing address

PO BOX 90601
COLUMBIA SC
29290-1601
US

V. Phone/Fax

Practice location:
  • Phone: 803-828-3022
  • Fax: 833-422-0158
Mailing address:
  • Phone: 803-828-3022
  • Fax: 833-422-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: LASHANDA WILSON
Title or Position: FOUNDER/CEO
Credential:
Phone: 803-828-3022