Provider Demographics
NPI:1215037007
Name:PRECIOUS HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:PRECIOUS HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:DELE
Authorized Official - Last Name:ADAGBON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-216-4517
Mailing Address - Street 1:705 BILL SHAW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-7529
Mailing Address - Country:US
Mailing Address - Phone:972-216-4517
Mailing Address - Fax:972-288-3500
Practice Address - Street 1:705 BILL SHAW DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-7529
Practice Address - Country:US
Practice Address - Phone:972-216-4517
Practice Address - Fax:972-288-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities