Prestige Group Home Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PRESTIGE GROUP HOME INC

Practice address

2278 SW Plymouth St
Port Saint Lucie, FL 34953-2379

Phone

(772) 879-4575

Fax

(772) 777-2088

NPI assigned

Nov 15, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Tanya Georges, RNNPI 1508600057

Title

Secretary/Director

Phone

(772) 349-8608

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Tanya Georges, APRN

  • Adult Medicine Physician
  • Port Saint Lucie, FL
  • NPI 1508600057
  NPD Authorized official

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1548979800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2278 SW PLYMOUTH ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532379",
            "fax_number": "772-777-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2278 SW PLYMOUTH ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532379",
            "telephone_number": "772-879-4575",
            "fax_number": "772-777-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE GROUP HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "GEORGES",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "SECRETARY/DIRECTOR",
        "authorized_official_telephone_number": "772-349-8608",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "685946196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Defatima Pozuelo, MD
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• James Jetrow Presley, M.D.
• Prima Vista Recovery and Wellness Center LLC
• Priority Care LLC (Home Helpers & Direct Link Office 58808)
• Pristine Helping Hands LLC
• Private Lab Care Elite, LLC
• Pro Medical Supply

• Developmentally Disabled Services Day Training Agency in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.