MEDICARE: PRESTIGE HOME CARE ASSISTANCE 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1922986975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE HOME CARE ASSISTANCE LLC

Provider Business Mailing Address
First Line	:	5132 ADDISON DR
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5132 ADDISON DR
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4430
Country	:	US
Telephone Number	:	586-262-7965
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROBERT ORAHA SR.
Credential	:
Telephone Number	:	586-262-7965

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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