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Organization
PRESTIGIOUS ONE SOURCE HOMECARE LLC
Active
Organization
PRESTIGIOUS ONE SOURCE HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALILAH TAYLOR RN, NP-C (CO-OWNER)
(919) 971-4642
Entity
Organization
Contact information
Practice address
3948 BROWNING PL STE 211, RALEIGH, NC 27609-6512
(919) 803-3006
Mailing address
3948 BROWNING PL STE 211, RALEIGH, NC 27609-6512
(919) 803-3006
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
10/24/2020
Last updated
10/30/2021
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