Healthcare Provider Details

I. General information

NPI: 1689150799
Provider Name (Legal Business Name): PRESTIGE ADULT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

866 E JERICHO TPKE
HUNTINGTON STATION NY
11746-7505
US

IV. Provider business mailing address

866 E JERICHO TPKE
HUNTINGTON STATION NY
11746-7505
US

V. Phone/Fax

Practice location:
  • Phone: 631-923-2262
  • Fax: 888-214-4343
Mailing address:
  • Phone: 631-923-2262
  • Fax: 888-214-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ORLETTE MILLER
Title or Position: CEO/OWNER
Credential:
Phone: 631-424-0510