Provider Demographics
NPI:1326615089
Name:PRESTIGE HEALTHCARE RESOURCES INC.
Entity Type:Organization
Organization Name:PRESTIGE HEALTHCARE RESOURCES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SAYE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:BSN
Authorized Official - Phone:240-644-3578
Mailing Address - Street 1:6011 EMERSON ST APT 209
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1829
Mailing Address - Country:US
Mailing Address - Phone:240-644-3578
Mailing Address - Fax:
Practice Address - Street 1:9500 MEDICAL CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-3703
Practice Address - Country:US
Practice Address - Phone:240-644-3578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2022-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty