Healthcare Provider Details

I. General information

NPI: 1003569930
Provider Name (Legal Business Name): PRECIOUS ESSENTIALS HEALTHCARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 RIVERPLACE BLVD STE 800
JACKSONVILLE FL
32207-9032
US

IV. Provider business mailing address

1301 RIVERPLACE BLVD STE 800
JACKSONVILLE FL
32207-9032
US

V. Phone/Fax

Practice location:
  • Phone: 866-604-2007
  • Fax:
Mailing address:
  • Phone: 866-604-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHALA SHENELL LOYD
Title or Position: OWNER
Credential:
Phone: 866-604-2007