Prestige Supervised Community Living Inc

Primary specialty

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

Legal business name

PRESTIGE SUPERVISED COMMUNITY LIVING INC

Practice address

1725 Northview Dr
Mobile, AL 36618-1801

Phone

(251) 370-3403

Fax

(251) 343-9322

NPI assigned

Jan 16, 2014

Last updated

Jan 16, 2014By 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. Robert Brown

Title

Ceo

Phone

(251) 370-3403

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1477975936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 NORTHVIEW DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366181801",
            "telephone_number": "251-370-3403",
            "fax_number": "251-343-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 NORTHVIEW DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366181801",
            "telephone_number": "251-370-3403",
            "fax_number": "251-343-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE SUPERVISED COMMUNITY LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-370-3403",
        "authorized_official_name_prefix": "Mr."
    },
    "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": []
}

• Premier Neurological Rehabilitation, LLC
• Premise Health of Alabama Medical PC (MAWSS - Mobile)
• Dottie Estes Presley, ALC, NCC
• Miranda Lace Presley
• Prestige Medical LLC
• Milton Dwight Prestridge Jr., M.D.
• Kevin E Prewett, MD
• Dezaraie Price-Grant
• Bailee Price
• Payton Elise Pridmore, PHARM.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Mobile, AL
• Providers in Mobile, AL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.