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General NPI Number Information
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NPI Number | 1922253780
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Entity Type | Organization
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Legal Business Name | PRECIOUS CARE LLC
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 4067 ALLEN ST
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City | INKSTER
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State | MI
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Zip | 48141-3005
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Country | US
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Telephone | 313-218-2249
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Fax |
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Provider Business Mailing Address
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Address Line | 18494 SALEM ST
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City | DETROIT
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State | MI
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Zip | 48219-3055
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Country | US
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Telephone | 313-218-2249
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Fax |
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MRS. DESTINY UNIQUE ARRINGTON
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Credential |
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Telephone | 313-218-2249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS820294671
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License Number State | MI
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