Healthcare Provider Details
I. General information
NPI: 1205758026
Provider Name (Legal Business Name): PRECIOUS COMMUNITY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 PEACHTREE LN
MIDDLETOWN DE
19709-9397
US
IV. Provider business mailing address
108 PEACHTREE LN
MIDDLETOWN DE
19709-9397
US
V. Phone/Fax
- Phone: 302-559-8573
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STELLAH
ONSOMU
Title or Position: MANAGING DIRECTOR
Credential: APRN
Phone: 302-559-8573