MEDICARE: PRECIOUS RELIANCE FAMILY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1063371318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECIOUS RELIANCE FAMILY CARE LLC

Provider Business Mailing Address
First Line	:	5690 ALEPPO LN
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-5087
Country	:	US
Telephone Number	:	651-307-7509
Fax Number	:	651-307-7509

Provider Business Practice Location Address
First Line	:	5690 ALEPPO LN
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-5087
Country	:	US
Telephone Number	:	651-307-7509
Fax Number	:	651-307-7509

Authorized Official
Title or Position	:	REGISTERED AGENT/ BUSINESS MANAGER
Name	:	RUDOLPH BALLAH
Credential	:
Telephone Number	:	260-580-6666

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/22/2026

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