Provider Demographics
NPI:1649236860
Name:PRESTIGE-PLUS HEALTH SERVICES INC
Entity Type:Organization
Organization Name:PRESTIGE-PLUS HEALTH SERVICES INC
Other - Org Name:PRESTIGE-PLUS HEALTH SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHINYERE
Authorized Official - Middle Name:EMILIA
Authorized Official - Last Name:OKONKWO
Authorized Official - Suffix:
Authorized Official - Credentials:RN BS
Authorized Official - Phone:972-747-0821
Mailing Address - Street 1:1101 RAINTREE CIR STE 210
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4935
Mailing Address - Country:US
Mailing Address - Phone:972-747-0821
Mailing Address - Fax:972-747-9215
Practice Address - Street 1:1101 RAINTREE CIR STE 210
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:972-747-0821
Practice Address - Fax:972-747-9215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010294251E00000X
3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162780401Medicaid
TX180864001Medicaid