Provider Demographics
NPI:1336943497
Name:PRISTINE CARE LLC
Entity type:Organization
Organization Name:PRISTINE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:O
Authorized Official - Last Name:UKATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-909-5539
Mailing Address - Street 1:3120 SOUTHWEST FWY STE 201964
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4509
Mailing Address - Country:US
Mailing Address - Phone:713-909-5539
Mailing Address - Fax:
Practice Address - Street 1:3120 SOUTHWEST FWY STE 201964
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4509
Practice Address - Country:US
Practice Address - Phone:713-909-5539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities