Provider Demographics
NPI:1659653285
Name:PRESTIGE REALTY SERVICES,INC.
Entity Type:Organization
Organization Name:PRESTIGE REALTY SERVICES,INC.
Other - Org Name:PRESTIGE PROFESSIONAL NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-424-9660
Mailing Address - Street 1:1165 RED FOX RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-9106
Mailing Address - Country:US
Mailing Address - Phone:570-424-9660
Mailing Address - Fax:570-424-9661
Practice Address - Street 1:1165 RED FOX RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-9106
Practice Address - Country:US
Practice Address - Phone:570-424-9660
Practice Address - Fax:570-424-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21483601313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility