Healthcare Provider Details

I. General information

NPI: 1619418993
Provider Name (Legal Business Name): PRECIOUS U LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 12/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 OXFORD CT
BELLEVILLE MI
48111-4927
US

IV. Provider business mailing address

305 OXFORD CT
BELLEVILLE MI
48111-4927
US

V. Phone/Fax

Practice location:
  • Phone: 517-574-6559
  • Fax: 734-922-5142
Mailing address:
  • Phone: 517-574-6559
  • Fax: 734-922-5142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. LAMONT LOGAN
Title or Position: OWNER
Credential:
Phone: 517-574-6559