Healthcare Provider Details

I. General information

NPI: 1336891852
Provider Name (Legal Business Name): PRESTIGE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 08/26/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR STE D1
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR STE D1
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 804-415-7576
  • Fax:
Mailing address:
  • Phone: 804-482-3580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: EVELYN TANDAU
Title or Position: ADMINISTRATOR
Credential:
Phone: 804-482-3580