Healthcare Provider Details

I. General information

NPI: 1457973802
Provider Name (Legal Business Name): PRECISION ADULT CARE SERVICES CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83113 LOS CABOS AVE
COACHELLA CA
92236-6320
US

IV. Provider business mailing address

83113 LOS CABOS AVE
COACHELLA CA
92236-6320
US

V. Phone/Fax

Practice location:
  • Phone: 760-835-1245
  • Fax: 760-249-7665
Mailing address:
  • Phone: 760-835-1245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA DOMINGUEZ
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 760-219-1033