Healthcare Provider Details

I. General information

NPI: 1326220401
Provider Name (Legal Business Name): PRECISE HOME HEALTH CARE SEVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E HARTFORD AVE STE C
PONCA CITY OK
74601-2057
US

IV. Provider business mailing address

900 E HARTFORD AVE STE C
PONCA CITY OK
74601-2057
US

V. Phone/Fax

Practice location:
  • Phone: 580-762-6000
  • Fax: 580-762-6003
Mailing address:
  • Phone: 580-762-6000
  • Fax: 580-762-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7879
License Number StateOK

VIII. Authorized Official

Name: MS. LORI ANN PRADO
Title or Position: OWNER/ADMINISTRATOR
Credential: D.C, B.S.N, R.N
Phone: 580-762-6000