Healthcare Provider Details

I. General information

NPI: 1558069849
Provider Name (Legal Business Name): PRECIOUS CARE HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S CENTRAL EXPY STE 304
RICHARDSON TX
75080-7424
US

IV. Provider business mailing address

811 S CENTRAL EXPY STE 304
RICHARDSON TX
75080-7424
US

V. Phone/Fax

Practice location:
  • Phone: 972-680-0096
  • Fax: 972-680-8318
Mailing address:
  • Phone: 972-680-0096
  • Fax: 972-680-8318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DERRICK NIBA
Title or Position: OWNER
Credential: RN
Phone: 972-680-0096