Healthcare Provider Details

I. General information

NPI: 1538090170
Provider Name (Legal Business Name): PRECIOUS GAINES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3308 COBBLESTONE CT
AUGUSTA GA
30906-5781
US

IV. Provider business mailing address

243 FIOLI CIR
GRANITEVILLE SC
29829-3987
US

V. Phone/Fax

Practice location:
  • Phone: 706-627-7668
  • Fax:
Mailing address:
  • Phone: 706-627-7668
  • Fax: 706-627-7668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: