Provider Demographics
NPI:1477245629
Name:PRESTIGE CASE MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:PRESTIGE CASE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:LONELL
Authorized Official - Last Name:THAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:702-470-3058
Mailing Address - Street 1:1 CHICK SPRINGS RD STE 203A-1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-4946
Mailing Address - Country:US
Mailing Address - Phone:864-900-4514
Mailing Address - Fax:
Practice Address - Street 1:1 CHICK SPRINGS RD STE 203A-1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4946
Practice Address - Country:US
Practice Address - Phone:864-900-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty