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General NPI Number Information
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NPI Number | 1508529199
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Entity Type | Organization
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Legal Business Name | PRESTIGE CARE SERVICES LLC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 200 6TH ST NW
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City | CANTON
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State | OH
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Zip | 44702-1005
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Country | US
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Telephone | 234-360-5705
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Fax |
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Provider Business Mailing Address
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Address Line | 200 6TH ST NW
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City | CANTON
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State | OH
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Zip | 44702-1005
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Country | US
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Telephone | 234-360-5705
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Fax |
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Authorized Official
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Title or Position | COO
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Name | SHANNON S MOSS
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Credential |
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Telephone | 330-313-0919
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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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