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General NPI Number Information
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NPI Number | 1720944119
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Entity Type | Organization
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Legal Business Name | PRESTIGE WELLNESS CENTER INC
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 7416 5TH AVE S
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City | RICHFIELD
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State | MN
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Zip | 55423-4333
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Country | US
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Telephone | 619-688-1381
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Fax | 952-288-7761
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Provider Business Mailing Address
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Address Line | 7416 5TH AVE S
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City | RICHFIELD
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State | MN
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Zip | 55423-4333
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Country | US
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Telephone | 619-688-1381
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Fax | 952-288-7761
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | QADRA M HASHI
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Credential | DIRECTOR
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Telephone | 619-866-1381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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