Provider Demographics
NPI:1902447832
Name:PRESTIGE HOME CARE LLC
Entity Type:Organization
Organization Name:PRESTIGE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANZVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-660-1326
Mailing Address - Street 1:317 MONMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3209
Mailing Address - Country:US
Mailing Address - Phone:732-267-4832
Mailing Address - Fax:
Practice Address - Street 1:515 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3606
Practice Address - Country:US
Practice Address - Phone:516-660-1326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care