Provider Demographics
NPI: | 1285405068 |
---|---|
Name: | AK & PRESTIGE LLC |
Entity type: | Organization |
Organization Name: | AK & PRESTIGE LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KIERRA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | REYNOLDS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 832-326-5586 |
Mailing Address - Street 1: | 17907 KUYKENDAHL RD STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | SPRING |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77379-8152 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 832-326-5586 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 17907 KUYKENDAHL RD STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | SPRING |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77379-8152 |
Practice Address - Country: | US |
Practice Address - Phone: | 832-326-5586 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-01-11 |
Last Update Date: | 2024-05-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | Group - Multi-Specialty | |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
No | 251E00000X | Agencies | Home Health | ||
No | 253Z00000X | Agencies | In Home Supportive Care | ||
No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness | |
No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances | |
No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | ||
No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | |
No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | ||
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 376J00000X | Nursing Service Related Providers | Homemaker | Group - Multi-Specialty | |
No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child | |
No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |