Provider Demographics
NPI:1215715305
Name:PRESTIGE HEALTHCARE RESOURCES INC.
Entity type:Organization
Organization Name:PRESTIGE HEALTHCARE RESOURCES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-462-6947
Mailing Address - Street 1:9500 MEDICAL CENTER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3703
Mailing Address - Country:US
Mailing Address - Phone:240-334-4394
Mailing Address - Fax:
Practice Address - Street 1:400 W FRANKLIN ST STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2152
Practice Address - Country:US
Practice Address - Phone:443-903-3686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health