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General NPI Number Information
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NPI Number | 1023298379
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Entity Type | Organization
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Legal Business Name | PRECIOUS HOME SERVICE INC.
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Dates
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Enumeration Date | 11/04/2007
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Last Update Date | 11/04/2007
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Provider Practice Location Address
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Address Line | 5511 102ND AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-2074
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Country | US
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Telephone | 736-425-2830
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Fax |
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Provider Business Mailing Address
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Address Line | 5511 102ND AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-2074
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Country | US
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Telephone | 763-435-2830
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Fax | 763-425-2830
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. NOSA OGIE
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Credential |
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Telephone | 763-425-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 334863
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 334862
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License Number State | MN
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