PRESTIGE HEALTH SERVICES LLC (NPI# 1497301170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497301170 |
| Entity Type | Organization |
| Organization Name | PRESTIGE HEALTH SERVICES LLC |
| Practice Address |
1770 Indian Trail Lilburn Rd Ste 420 Norcross GA 30093-2644 |
| Mailing Address |
2860 Summit Valley Dr Dacula GA 30019-4008 |
| Practice Telephone | 4044752600 |
| Mailing Telephone | 6785712528 |
| Enumeration Date | 2019-08-17 |
| Last Update Date | 2019-08-17 |
| Authorized Official Name | CHRISTINE CLERIZIER (CEO/RN) |
| Authorized Official Telephone | 6785712528 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities | ||
| Y | 251E00000X | Home Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000111222333 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Prestige Health Services LLC | 18583 Split Rock Lane, Germantown, Maryland 22311 |
| Street Address |
1770 INDIAN TRAIL LILBURN RD STE 420 |
| City | NORCROSS |
| State | GA |
| Zip Code | 30093-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517465 | Tequila Olivia Banks | Counselor | 8303 Dunleaf Arc Way Nw, Norcross, GA 30093 | 2020-10-27 |
| 1922643485 | Anthony Ervin | Case Manager/Care Coordinator | 6251 Smithpoint Dr. Bldg B, Peachtree Corners, GA 30093 | 2019-11-08 |
| 1164908885 | Marianne Altares | Speech-Language Pathologist | 1709 Oakbrook Lake Dr, Norcross, GA 30093 | 2018-07-16 |
| 1518480763 | Braces Now 14, LLC | Dentist | 4141 Steve Reynolds Blvd, Suite 2, Norcross, GA 30093 | 2017-07-19 |
| 1457802902 | Audrey Fernandes | Dentist | 4846 Jimmy Carter Blvd, Suite 203, Norcross, GA 30093 | 2016-10-19 |
| 1922456318 | Diana Lleras | Counselor | 6020 Dawson Bld Suite I, Norcross, GA 30093 | 2016-05-26 |
| 1376941500 | Katerine Velez | Counselor | 6020 Dawson Blvd., Siute I, Norcross, GA 30093 | 2014-12-22 |
| 1679979017 | Allison Ballay Donnelly | Speech-Language Pathologist | 1626 Jeurgens Ct., Norcross, GA 30093 | 2014-11-12 |
| 1588913701 | Sunrise Pharmacy | Pharmacy | 1235 Indian Trail Rd, Suite 200a, Norcross, GA 30093 | 2012-09-04 |
| 1821347154 | Shakirah Forde | Counselor | 1770 Indian Trail Lilburn Rd Ste 120, Norcross, GA 30093 | 2012-08-31 |
| Find all providers in zip 30093 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235787151 | Crystal Davy | Home Health | 4043 Northridge Way Apt 7, Norcross, GA 30093-3243 | 2019-09-04 |
| 1700434081 | Duluth Healthcare Systems LLC | Home Health | 1254 Beaver Ruin Rd Ste 302, Norcross, GA 30093-3224 | 2019-08-29 |
| 1336653682 | Shelice Delcenia Johnson | Home Health | 3236 Sunrise Village Ln Apt B, Norcross, GA 30093-5478 | 2017-11-23 |
| 1942727094 | Simpli Serenity Home Care Services, LLC | Home Health | 4777 Greenway Rd, Norcross, GA 30071-3832 | 2017-08-29 |
| 1255868949 | Golden Age Home Care LLC | Home Health | 4845 Jimmy Carter Blvd, Norcross, GA 30093-3641 | 2017-05-12 |
| 1104377423 | Viet Home Care LLC | Home Health | 6040 Dawson Blvd Ste H, Norcross, GA 30093-1258 | 2016-10-21 |
| 1861887499 | Bestway Homecare and Family Solutions, LLC | Home Health | 5627 Singleton Rd, Norcross, GA 30093-2208 | 2015-03-31 |
| 1760720783 | Horizon Healthcare Services | Home Health | 1440 Elm Creek Ln, Norcross, GA 30093-2706 | 2013-01-25 |
| 1447509195 | Atlanta Caregivers and Associates LLC | Home Health | 1254 Beaver Ruin Rd Ste 305, Norcross, GA 30093-3005 | 2012-09-07 |
| 1447558010 | Mofazzal Suraiya LLC | Home Health | 1015 Omaha Dr, Norcross, GA 30093-4967 | 2011-03-07 |
| Find all providers in NORCROSS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.