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
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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