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General NPI Number Information
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NPI Number | 1184531410
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Entity Type | Organization
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Legal Business Name | PRISTINE HOME SERVICES LLC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 2342 HILL ST APT H
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City | PETERSBURG
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State | VA
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Zip | 23803-2774
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Country | US
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Telephone | 804-719-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 744 W OGLETHORPE HWY UNIT 1184
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City | HINESVILLE
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State | GA
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Zip | 31310-7749
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Country | US
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Telephone | 804-719-0026
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Fax |
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Authorized Official
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Title or Position | ADMINISTER
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Name | LONNIE REID JR.
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Credential |
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Telephone | 912-719-0026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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