Healthcare Provider Details

I. General information

NPI: 1114489184
Provider Name (Legal Business Name): PRECIOUS MOMENTS HOME HEALTHCARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3876 GENEVIEVE BLVD
STOW OH
44224-3528
US

IV. Provider business mailing address

3876 GENEVIEVE BLVD
STOW OH
44224-3528
US

V. Phone/Fax

Practice location:
  • Phone: 440-494-4169
  • Fax:
Mailing address:
  • Phone: 440-494-4169
  • 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: STEPHANIE LEWIS-MCCAULLEY
Title or Position: OWNER
Credential:
Phone: 216-727-7203