Organization · NPI-2
Prestige Companion Services
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Apopka, FL
NPI number1184409054
StatusActive
Last updated in NPPESAug 29, 2023
Details
- NPI
- 1184409054
- Entity type
- Organization (NPI-2)
- Legal business name
- Prestige Companion Services
- Organization subpart
- No
- Enumeration date
- Aug 29, 2023
- Certification date
- Aug 29, 2023
- Last updated
- Aug 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
| 251E00000X | Home Health | – | – | |
| 261QD1600X | Clinic/Center, Developmental Disabilities | – | – |
Practice location
2429 Cerberus DrApopka, FL 32712-4759
Phone 850-264-5509
Mailing address
2429 Cerberus DrApopka, FL 32712-4759
Authorized official
Keneshia Holmes
Ceo
8502645509
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