Provider Demographics
NPI:1124392527
Name:PRESTIGE ADULT DAYCARE AND HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PRESTIGE ADULT DAYCARE AND HOME HEALTH SERVICES LLC
Other - Org Name:PRESTIGE TRANSPORTSTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARWAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALHISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-501-7966
Mailing Address - Street 1:2650 COURTRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4840
Mailing Address - Country:US
Mailing Address - Phone:614-501-7966
Mailing Address - Fax:614-501-7967
Practice Address - Street 1:2650 COURTRIGHT ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232
Practice Address - Country:US
Practice Address - Phone:614-501-7966
Practice Address - Fax:614-501-7967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH259075343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)