Provider Demographics
NPI:1306317201
Name:PRESTIGE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:PRESTIGE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-499-3058
Mailing Address - Street 1:1103 VALLEYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5578
Mailing Address - Country:US
Mailing Address - Phone:845-499-3058
Mailing Address - Fax:
Practice Address - Street 1:529 SEVEN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7608
Practice Address - Country:US
Practice Address - Phone:845-499-3058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care