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General NPI Number Information
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NPI Number | 1174291686
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Entity Type | Organization
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Legal Business Name | PRESTIGE HOME CARE LLC
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 5706 TERRIER PL
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City | MORRISVILLE
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State | NC
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Zip | 27560-6367
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Country | US
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Telephone | 919-482-8917
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Fax |
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Provider Business Mailing Address
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Address Line | 2608 ERWIN RD STE 148-282
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City | DURHAM
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State | NC
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Zip | 27705-4596
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Country | US
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Telephone | 919-482-8917
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Fax |
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Authorized Official
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Title or Position | OWNER/ CHIEF EXECUTIVE OFFICER
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Name | MS. CHARQUALIA NA'SHAI PERRY
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Credential |
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Telephone | 919-482-8917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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