Organization
PRESTIGE GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANYA GEORGES RN (SECRETARY/DIRECTOR)
(772) 349-8608
Entity
Organization
Contact information
Practice address
2278 SW PLYMOUTH ST, PORT SAINT LUCIE, FL 34953-2379
(772) 879-4575
(772) 777-2088
Mailing address
2278 SW PLYMOUTH ST, PORT SAINT LUCIE, FL 34953-2379
(772) 777-2088
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685946196
—
FL
Enumeration date
11/15/2022
Last updated
11/15/2022
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