Healthcare Provider Details

I. General information

NPI: 1265639488
Provider Name (Legal Business Name): PRECIOUS HOME HEALTH AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1053 COLORADO BLVD SUITE E
EAGLE ROCK CA
90041-2572
US

IV. Provider business mailing address

1053 COLORADO BLVD SUITE E
EAGLE ROCK CA
90041-2572
US

V. Phone/Fax

Practice location:
  • Phone: 323-257-8940
  • Fax: 323-257-8949
Mailing address:
  • Phone: 323-257-8940
  • Fax: 323-257-8949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. VAHE BALDEMIAN
Title or Position: CEO
Credential:
Phone: 323-257-8940