Prestige Residential Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PRESTIGE RESIDENTIAL SERVICES LLC

Practice address

10493 Serviceberry Dr
Indianapolis, IN 46234-0169

Phone

(701) 339-8204

NPI assigned

Nov 29, 2023

Organization subpart

No

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

Authorized official

Name

Gaethan NdayongejeNPI 1467259960

Title

President

Phone

(701) 339-8204

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gaethan Ndayongeje

  • Behavior Technician
  • Indianapolis, IN
  • NPI 1467259960
  NPD Authorized official

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1124894233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10493 SERVICEBERRY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462340169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10493 SERVICEBERRY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462340169",
            "telephone_number": "701-339-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "NDAYONGEJE",
        "authorized_official_first_name": "GAETHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-339-8204"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jourdan Pressler
• Laurin Ashlee Pressley, FNP-C
• Robert G Presson Jr., MD
• Keaton Presti-Stringfellow
• Prestige Residential Cares, LLC
• Prestige Transportation Services
• Eugene P Presto, DO
• Desmond Ira Preston
• Evelyn-Rose Preston, RBT
• Shelby Nichole Preston, RDN

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.