Healthcare Provider Details

I. General information

NPI: 1790562064
Provider Name (Legal Business Name): PRESTIGE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 HERESFORD DR
PARMA OH
44134-3410
US

IV. Provider business mailing address

3106 HERESFORD DR
PARMA OH
44134-3410
US

V. Phone/Fax

Practice location:
  • Phone: 216-703-9527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. PRABESH ADHIKARI
Title or Position: OWNER
Credential:
Phone: 440-589-9715