Provider Demographics
NPI:1659079853
Name:PRESTIGE CARE SERVICES
Entity Type:Organization
Organization Name:PRESTIGE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:NNAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-375-9718
Mailing Address - Street 1:5555 LONG PRAIRIE TRCE APT 534
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1775
Mailing Address - Country:US
Mailing Address - Phone:832-375-9718
Mailing Address - Fax:
Practice Address - Street 1:617 COUNTY ROAD 99
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-7683
Practice Address - Country:US
Practice Address - Phone:832-375-9718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children