Provider Demographics
NPI:1427378058
Name:PRECIOUS LIVING INCORPORATED
Entity Type:Organization
Organization Name:PRECIOUS LIVING INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:POUNDSBUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-465-2505
Mailing Address - Street 1:448 REGISTRY BLF
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6602
Mailing Address - Country:US
Mailing Address - Phone:770-465-2505
Mailing Address - Fax:770-465-2505
Practice Address - Street 1:448 REGISTRY BLF
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-6602
Practice Address - Country:US
Practice Address - Phone:770-465-2505
Practice Address - Fax:770-465-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044016471315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities