Provider Demographics
NPI:1235637505
Name:PRECIOUS WORC'S INC.
Entity Type:Organization
Organization Name:PRECIOUS WORC'S INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TISHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:UMEADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-309-0119
Mailing Address - Street 1:131 IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6303
Practice Address - Country:US
Practice Address - Phone:917-309-0119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid