Provider Demographics
NPI:1730578980
Name:PRECIOUS CARE AT HOME SERVICES INC
Entity type:Organization
Organization Name:PRECIOUS CARE AT HOME SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NAILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-425-2273
Mailing Address - Street 1:1735 MARKET ST
Mailing Address - Street 2:SUITE 3750
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-7501
Mailing Address - Country:US
Mailing Address - Phone:267-507-6156
Mailing Address - Fax:267-507-6150
Practice Address - Street 1:1735 MARKET ST
Practice Address - Street 2:SUITE 3750
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-7501
Practice Address - Country:US
Practice Address - Phone:267-507-6156
Practice Address - Fax:267-507-6150
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECIOUS CARE AT HOME SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05520501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215964200Medicaid
VA1194901496OtherHOME CARE