Provider Demographics
NPI:1144620238
Name:PRESTIGE HOME HEALTH AGENCY I
Entity Type:Organization
Organization Name:PRESTIGE HOME HEALTH AGENCY I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHUKS
Authorized Official - Last Name:NNAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-924-1594
Mailing Address - Street 1:929 PECAN TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3169
Mailing Address - Country:US
Mailing Address - Phone:214-924-1594
Mailing Address - Fax:972-291-2352
Practice Address - Street 1:929 PECAN TRL
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3169
Practice Address - Country:US
Practice Address - Phone:214-924-1594
Practice Address - Fax:972-291-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health