Prestige Residential Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PRESTIGE RESIDENTIAL CARE LLC

Practice address

48 Arnies Aly # 48
Westbrook, ME 04092-2365

Phone

(407) 985-0174

NPI assigned

Dec 23, 2024

Last updated

Dec 23, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul Mukomeza

Title

Chief Executive Officer

Phone

(407) 985-0174

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1043028079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ARNIES ALY # 48",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922365",
            "telephone_number": "407-985-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 ARNIES ALY # 48",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922365",
            "telephone_number": "407-985-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-22",
        "status": "A",
        "authorized_official_last_name": "MUKOMEZA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "407-985-0174",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara J Powers, MD
• Jane Gair Prairie, LCSW
• Peter Preble, LC3966, CCS4250
• Gretchen F Preneta, PA-C
• David S Prescott, LCSW, LICSW
• Professional Healthcare Training
• Prudential Transportation
• Kasey L. Prunier, PA-C
• Mark R Publicker, M.D.
• David Pulsifer, BCBA

• In Home Supportive Care Agency in Westbrook, ME
• Providers in Westbrook, ME by specialty
• In Home Supportive Care Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.