Provider Demographics
NPI:1114489184
Name:PRECIOUS MOMENTS HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:PRECIOUS MOMENTS HOME HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS-MCCAULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-727-7203
Mailing Address - Street 1:1849 COLONNADE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1567
Mailing Address - Country:US
Mailing Address - Phone:216-727-8186
Mailing Address - Fax:
Practice Address - Street 1:1849 COLONNADE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1567
Practice Address - Country:US
Practice Address - Phone:216-727-8186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health