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General NPI Number Information
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NPI Number | 1124273800
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Entity Type | Organization
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Legal Business Name | PRECIOUS LINK HOMEHEALTH
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 1005 YORK DR SUITE 105A
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City | DESOTO
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State | TX
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Zip | 75115-2083
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Country | US
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Telephone | 972-572-9998
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Fax | 972-572-9990
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Provider Business Mailing Address
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Address Line | 1005 YORK DR SUITE 105A
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City | DESOTO
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State | TX
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Zip | 75115-2083
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Country | US
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Telephone | 972-572-9998
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Fax | 972-572-9990
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. MICHAEL ADETULA
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Credential | ND., RPH
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Telephone | 972-572-9998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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