=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386251718
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRSM SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2020
-----------------------------------------------------
Last Update Date | 05/13/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 930 W INDIANTOWN RD STE 203
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33458-6841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-741-1200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10130 NORTHLAKE BLVD STE 214-168
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33412-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-610-6982
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER/BRANCH MANAGER
-----------------------------------------------------
Name | MRS. ANIQUE R BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-610-6982
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------