Healthcare Provider Details

I. General information

NPI: 1568814689
Provider Name (Legal Business Name): PRECIOUS ADULT CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 FAGAN RD
WINNSBORO SC
29180-9584
US

IV. Provider business mailing address

121 FAGAN RD
WINNSBORO SC
29180-9584
US

V. Phone/Fax

Practice location:
  • Phone: 803-635-3755
  • Fax:
Mailing address:
  • Phone: 803-635-3755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIHCP-0207
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberADC-0173
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON JOHNSON BATES
Title or Position: BUSINESS MANAGER
Credential:
Phone: 803-635-3755