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General NPI Number Information
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NPI Number | 1285384388
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Entity Type | Organization
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Legal Business Name | PRESTIGE MANOR BUSINESS LLC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 6040 SE FRONT RD
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City | BELLEVIEW
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State | FL
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Zip | 34420-3326
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Country | US
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Telephone | 469-739-6473
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Fax |
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Provider Business Mailing Address
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Address Line | 6333 SE BABB RD
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City | BELLEVIEW
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State | FL
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Zip | 34420-4280
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Country | US
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Telephone | 469-739-6473
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SYED HUSAIN
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Credential |
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Telephone | 903-618-0731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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