Prestige Senior Enrichment Center Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PRESTIGE SENIOR ENRICHMENT CENTER INC

Doing business as

Prestige Enrichment Center INC

Practice address

2104 Northbay Dr
Browns Summit, NC 27214-8701

Phone

(336) 912-8462

Fax

(336) 763-8405

NPI assigned

Mar 27, 2019

Last updated

Mar 27, 2019By 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

Mrs. Kimberly Lide

Title

President

Phone

(336) 340-4734

Specialties & licenses 5

Addresses

Other names 1

• Prestige Enrichment Center INC Doing business as

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1124589528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 NORTHBAY DR",
            "city": "BROWNS SUMMIT",
            "state": "NC",
            "postal_code": "272148701",
            "telephone_number": "336-912-8462",
            "fax_number": "336-763-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 NORTHBAY DR",
            "city": "BROWNS SUMMIT",
            "state": "NC",
            "postal_code": "272148701",
            "telephone_number": "336-912-8462",
            "fax_number": "336-763-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE SENIOR ENRICHMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "LIDE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-340-4734",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Enrichment Center INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NP Primary Care House Calls (Primary Care)
• Francisca Okafor
• Ariane Michelle Omari, MSW, LCSW-A
• Warren T Pickard II, MD
• Malesha Poole
• R.J. Whitsett Residential Facility
• R.J. Whitsett Residential Services, Inc.
• Gloria Ramirez
• Regent Therapy L.L.C.
• Roslyn Reynolds

• Mental Health Clinic/Center (Including Community Mental Health Center) in Browns Summit, NC
• Providers in Browns Summit, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.