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Organization

PRESTIGE HEALTH SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAKEDA ESSIM (PROGRAM DIRECTOR)
(571) 351-3476
Entity
Organization

Contact information

Practice address
4506 WHISTLER CT, ANNANDALE, VA 22003-4545
(571) 351-3476
Mailing address
4506 WHISTLER CT, ANNANDALE, VA 22003-4545
(571) 351-3476

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
12/03/2021
Last updated
12/03/2021
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