Healthcare Provider Details

I. General information

NPI: 1932954484
Provider Name (Legal Business Name): PRECIOUS U LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14853 COLLEGE AVE
ALLEN PARK MI
48101-3040
US

IV. Provider business mailing address

14853 COLLEGE AVE
ALLEN PARK MI
48101-3040
US

V. Phone/Fax

Practice location:
  • Phone: 313-318-4055
  • Fax:
Mailing address:
  • Phone: 313-318-4055
  • Fax:

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: LAMONT SCOTT LOGAN
Title or Position: OWNER
Credential:
Phone: 734-922-5142