Provider Demographics
NPI:1356930069
Name:PRESSENTIAL SUPPORTIVE SERVICES, LLC.
Entity type:Organization
Organization Name:PRESSENTIAL SUPPORTIVE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PROFESSIONAL GUARDIA
Authorized Official - Phone:305-762-2049
Mailing Address - Street 1:PO BOX 849171
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33084-1171
Mailing Address - Country:US
Mailing Address - Phone:305-762-2049
Mailing Address - Fax:
Practice Address - Street 1:7451 RIVIERA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6567
Practice Address - Country:US
Practice Address - Phone:305-762-2049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management