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General NPI Number Information
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NPI Number | 1669843777
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Entity Type | Organization
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Legal Business Name | PRECIOUS HOMES
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 9420 PINEHAVEN DR
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City | DALLAS
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State | TX
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Zip | 75227-4759
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Country | US
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Telephone | 469-544-9013
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Fax |
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Provider Business Mailing Address
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Address Line | 3405 ROCKCREST DR
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City | GARLAND
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State | TX
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Zip | 75044-6513
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER / PROGRAM MANAGER
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Name | MRS. MAURINE ACHILIKE
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Credential |
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Telephone | 469-544-9013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | TX
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