Organization
PRESTIGE HOME HEALTH CARE L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARANDELL CASTRO LPN (OWNER)
(816) 663-4350
Entity
Organization
Contact information
Practice address
1428 S PEARL ST, INDEPENDENCE, MO 64055-1430
(816) 663-4350
Mailing address
1428 S PEARL ST, INDEPENDENCE, MO 64055-1430
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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