Provider Demographics
NPI:1942665088
Name:PRISTINE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:PRISTINE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:SERAPHIN
Authorized Official - Last Name:ADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-261-9571
Mailing Address - Street 1:2823 SHADOW CANYON LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2425
Mailing Address - Country:US
Mailing Address - Phone:713-261-9571
Mailing Address - Fax:281-564-7326
Practice Address - Street 1:2823 SHADOW CANYON LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2425
Practice Address - Country:US
Practice Address - Phone:713-261-9571
Practice Address - Fax:281-564-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based