Healthcare Provider Details

I. General information

NPI: 1639596869
Provider Name (Legal Business Name): PRECIOUS MEDICAL HEALTH SER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25000 EUCLID AVE #408
EUCLID OH
44117
US

IV. Provider business mailing address

25000 EUCLID AVE #408
EUCLID OH
44117
US

V. Phone/Fax

Practice location:
  • Phone: 216-289-7647
  • Fax: 877-262-2161
Mailing address:
  • Phone: 216-289-7647
  • Fax: 877-262-2161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MS. YOLONDA P HENDKING
Title or Position: C.E.O PRESIDENT
Credential:
Phone: 216-289-7647