Organization
PRESTIGE CARE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HABEEBET MOMOH (PRESIDENT)
(786) 897-0213
Entity
Organization
Contact information
Practice address
17076 NW 17TH ST, PEMBROKE PINES, FL 33028-1354
(786) 897-0213
(954) 538-8664
Mailing address
17076 NW 17TH ST, PEMBROKE PINES, FL 33028-1354
(786) 897-0213
(954) 538-8664
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
000399500
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730403734
NPI
FL
Enumeration date
02/18/2011
Last updated
02/18/2011
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