Provider Demographics
NPI:1235012493
Name:PRESTINE WELL BEYOND INC
Entity type:Organization
Organization Name:PRESTINE WELL BEYOND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ENOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAPOYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-701-6546
Mailing Address - Street 1:7267 SWAN POINT WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5052
Mailing Address - Country:US
Mailing Address - Phone:202-701-6546
Mailing Address - Fax:
Practice Address - Street 1:7267 SWAN POINT WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5052
Practice Address - Country:US
Practice Address - Phone:202-701-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities