Healthcare Provider Details

I. General information

NPI: 1306752902
Provider Name (Legal Business Name): PRECIOUS ONES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 WHEATON AVE
SAINT LOUIS MO
63114-4643
US

IV. Provider business mailing address

3011 WHEATON AVE
SAINT LOUIS MO
63114-4643
US

V. Phone/Fax

Practice location:
  • Phone: 557-214-1219
  • Fax:
Mailing address:
  • Phone: 557-214-1219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELIN FOWLER
Title or Position: CEO
Credential:
Phone: 557-214-1219