Provider Demographics
NPI:1861741415
Name:PRECIOUS GEMS HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PRECIOUS GEMS HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:RADOVANIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-785-1482
Mailing Address - Street 1:850 EUCLID AVE
Mailing Address - Street 2:SUITE 950
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114
Mailing Address - Country:US
Mailing Address - Phone:216-339-4491
Mailing Address - Fax:216-848-1401
Practice Address - Street 1:850 EUCLID AVE
Practice Address - Street 2:SUITE 950
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114
Practice Address - Country:US
Practice Address - Phone:216-339-4491
Practice Address - Fax:216-848-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2013-07-24
Deactivation Date:2013-07-05
Deactivation Code:
Reactivation Date:2013-07-24
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health