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Organization
PRESTIGE COMPANION CARE, LLC
Active
Organization
PRESTIGE COMPANION CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY RANDALL MOORE (CEO)
(602) 456-9358
Entity
Organization
Contact information
Practice address
522 N CENTRAL AVE, PHOENIX, AZ 85004-2185
(480) 331-3815
Mailing address
522 N CENTRAL AVE, PHOENIX, AZ 85004-2185
(480) 331-3815
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
NULL
163WH0200X
Home Health Registered Nurse
—
—
171400000X
Health & Wellness Coach
—
NULL
171400000X
Health & Wellness Coach
—
—
251E00000X
Home Health Agency
Primary
—
NULL
332U00000X
Home Delivered Meals
—
NULL
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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