Provider Demographics
NPI:1407456486
Name:PRECIOUS BLESSINGS HOME & RESIDENTIAL CARE, LLC
Entity Type:Organization
Organization Name:PRECIOUS BLESSINGS HOME & RESIDENTIAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:LAVONNE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-306-0135
Mailing Address - Street 1:2002 EMMET ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68110-1817
Mailing Address - Country:US
Mailing Address - Phone:402-306-0135
Mailing Address - Fax:
Practice Address - Street 1:2002 EMMET ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-1817
Practice Address - Country:US
Practice Address - Phone:402-306-0135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care