Organization
PRESTIGE HEALTH CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TABITHA R KYAMBADDE (ADMINISTRATOR)
(763) 607-5184
Entity
Organization
Contact information
Practice address
10937 ROBINSON DR NW, COON RAPIDS, MN 55433-4248
(763) 607-5184
(763) 226-2378
Mailing address
10937 ROBINSON DR NW, COON RAPIDS, MN 55433-4248
(763) 607-5184
(763) 226-2378
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
337387
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337386
CLASS F
MN
01
—
337387
CLASS A
MN
Enumeration date
08/23/2007
Last updated
08/23/2007
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