Provider Demographics
NPI:1235419482
Name:PRESTIGE MANOR OF CORAL SPRINGS
Entity Type:Organization
Organization Name:PRESTIGE MANOR OF CORAL SPRINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GANGASINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-346-8031
Mailing Address - Street 1:11461 NW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7226
Mailing Address - Country:US
Mailing Address - Phone:954-346-8031
Mailing Address - Fax:
Practice Address - Street 1:11461 NW 39TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-7226
Practice Address - Country:US
Practice Address - Phone:954-346-8031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9591253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care