Prestige Residential Home LLC
NPI #1154061398 in Queen Creek, Arizona
Provider Information
- NPI Number
- 1154061398
- Entity Type
- Organization
- Organization Name
- Prestige Residential Home LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Mar 29, 2022
- Last Updated
- Mar 29, 2022
Practice Location
- Address
- 22367 E DESERT SPOON DR
- City
- Queen Creek
- State
- Arizona
- ZIP Code
- 85142-1235
- Phone
- (480) 307-9984
Authorized Official
- Name
- ALEXANDER B ASIEDU
- Title
- ADMINISTRATOR
- Phone
- (914) 417-0214
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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| Lyddia Getaweru, MBA, LNHA, ALM |
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