Organization
PRESTIGE CARE HOME
Active
Parent organization
PRESTIGE CARE HOME
Other names
Angelic Visits Senior Support Agency
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRESTIGE CARE HOME
Authorized official
SHIRLEY SPILLER-JOHNSON LPN (OWNER/ADMINISTRATOR)
(901) 281-8292
Entity
Organization
Contact information
Practice address
2051 MONTREAT DR, MEMPHIS, TN 38134-6613
(901) 281-8292
(901) 388-7366
Mailing address
2051 MONTREAT DR, MEMPHIS, TN 38134-6613
(901) 281-8292
(901) 388-7366
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
0000000565
TN
310400000X
Assisted Living Facility
Primary
0000000565
TN
311500000X
Alzheimer Center (Dementia Center)
0000000565
TN
311Z00000X
Custodial Care Facility
0000000565
TN
311ZA0620X
Adult Care Home Facility
0000000565
TN
385H00000X
Respite Care
0000000565
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445488
—
TN
Enumeration date
01/07/2015
Last updated
01/07/2015
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