Provider Demographics
NPI:1558873695
Name:PRESTIGE IN HOME CARE SOLUTIONS
Entity Type:Organization
Organization Name:PRESTIGE IN HOME CARE SOLUTIONS
Other - Org Name:PRESTIGE CARE SOLUTIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BSN, RN
Authorized Official - Prefix:
Authorized Official - First Name:SHANELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-761-8002
Mailing Address - Street 1:774 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:774 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-3134
Practice Address - Country:US
Practice Address - Phone:314-762-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESTIGE CARE SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-30
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No385H00000XRespite Care FacilityRespite Care