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General NPI Number Information
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NPI Number | 1992345599
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Entity Type | Organization
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Legal Business Name | PRESTIGE PERSONAL CARE SERVICES, LLC
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 1565 EBENEZER RD STE 148
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City | ROCK HILL
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State | SC
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Zip | 29732-2494
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Country | US
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Telephone | 803-659-7650
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 90601
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City | COLUMBIA
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State | SC
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Zip | 29290-1601
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Country | US
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Telephone | 803-828-3022
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Fax | 833-422-0158
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Authorized Official
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Title or Position | OWNER
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Name | LASHANDA WILSON
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Credential |
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Telephone | 803-828-3022
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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