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NPI Code Detail

MEDICARE: PRESTIGE ELDERLY SUPPORT CARE LLC

MEDICARE: PRESTIGE ELDERLY SUPPORT CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1427906601
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESTIGE ELDERLY SUPPORT CARE LLC
Provider Business Mailing Address
First Line : 3301 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1835
Country : US
Telephone Number : 702-505-8225
Fax Number : 702-760-0965
Provider Business Practice Location Address
First Line : 3301 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1835
Country : US
Telephone Number : 702-505-8225
Fax Number : 702-760-0965
Authorized Official
Title or Position : ADMINISTRATOR/OWNER
Name : MR. ROBERTO MORENO PANGILINAN
Credential : RN
Telephone Number : 702-505-8225
Provider Enumeration Date : 03/21/2026
Last Update Date : 03/21/2026

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Directions to “PRESTIGE ELDERLY SUPPORT CARE LLC ” Practice Location

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