NPIMap

Organization Active NPI

Prestige ABA Services LLC

  • Home Health Agency
  • Lehigh Acres, FL
National Provider Identifier
1609643238
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRESTIGE ABA SERVICES LLC
Practice address
621 Willard Ave
Lehigh Acres, FL 33972-7930
Phone
(786) 317-0100
Fax
(813) 776-1620
NPI assigned
Dec 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Mairelys ConcepcionNPI 1245732387
Title
Owner
Phone
(786) 317-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

621 Willard Ave
Lehigh Acres, FL 33972-7930

Mailing address

621 Willard Ave
Lehigh Acres, FL 33972-7930
Phone (786) 317-0100

National Provider Directory

National Provider Directory
Tax ID family
Prestige ABA Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1609643238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 WILLARD AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727930",
            "telephone_number": "786-317-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 WILLARD AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727930",
            "telephone_number": "786-317-0100",
            "fax_number": "813-776-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION",
        "authorized_official_first_name": "MAIRELYS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-317-0100"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.