Provider Demographics
NPI:1366120578
Name:PRESTIGIOUS HOME CARE SERVICES
Entity type:Organization
Organization Name:PRESTIGIOUS HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:855-707-7770
Mailing Address - Street 1:1816 BAIRSFORD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3007
Mailing Address - Country:US
Mailing Address - Phone:855-707-7770
Mailing Address - Fax:
Practice Address - Street 1:1816 BAIRSFORD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-3007
Practice Address - Country:US
Practice Address - Phone:855-707-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESTIGIOUS HOME CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care