Provider Demographics
NPI:1215595673
Name:PRESTIGIOUS PERSONAL CARE SERVICES OF AUGUST SERVICES LLC
Entity Type:Organization
Organization Name:PRESTIGIOUS PERSONAL CARE SERVICES OF AUGUST SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-990-5910
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-0294
Mailing Address - Country:US
Mailing Address - Phone:775-990-5910
Mailing Address - Fax:775-582-1314
Practice Address - Street 1:2200 E CALVADA BLVD STE D
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5833
Practice Address - Country:US
Practice Address - Phone:775-990-5910
Practice Address - Fax:775-582-1314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUGUST SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-31
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
01OtherPRIVATE PAY