Healthcare Provider Details

I. General information

NPI: 1215964200
Provider Name (Legal Business Name): PRECIOUS CARE AT HOME SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 MATHY DR
FAIRFAX VA
22031-5310
US

IV. Provider business mailing address

3733 PERSIMMON CIR
FAIRFAX VA
22031-4116
US

V. Phone/Fax

Practice location:
  • Phone: 703-425-2273
  • Fax: 703-425-2274
Mailing address:
  • Phone: 703-764-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. NAILEY MARY COLE
Title or Position: PRESIDENT
Credential: RN
Phone: 703-764-1003