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General NPI Number Information
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NPI Number | 1689972457
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Entity Type | Organization
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Legal Business Name | PRESTIGE HOME HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 400 E 2ND ST SUITE A
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-3808
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Country | US
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Telephone | 956-716-8505
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Fax | 956-716-8915
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Provider Business Mailing Address
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Address Line | 400 E 2ND ST SUITE A
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-3808
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Country | US
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Telephone | 956-716-8505
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Fax | 956-716-8915
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SERGIO TREVINO
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Credential | R.N.
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Telephone | 956-716-8505
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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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