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General NPI Number Information
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NPI Number | 1659653285
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Entity Type | Organization
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Legal Business Name | PRESTIGE REALTY SERVICES,INC.
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 1165 RED FOX RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9106
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Country | US
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Telephone | 570-424-9660
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Fax | 570-424-9661
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Provider Business Mailing Address
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Address Line | 1165 RED FOX RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9106
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Country | US
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Telephone | 570-424-9660
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Fax | 570-424-9661
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. HEIDEMARIE HAFNER
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Credential | R.N.
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Telephone | 570-424-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 21483601
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License Number State | PA
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