Provider Demographics
NPI:1477784346
Name:PRECISE HOME COMPANIONS
Entity Type:Organization
Organization Name:PRECISE HOME COMPANIONS
Other - Org Name:SAME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COMPANION OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:IV
Authorized Official - Credentials:CNA
Authorized Official - Phone:941-580-0622
Mailing Address - Street 1:82115TH ST EAST
Mailing Address - Street 2:821
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208
Mailing Address - Country:US
Mailing Address - Phone:941-747-8968
Mailing Address - Fax:941-749-5669
Practice Address - Street 1:821 15TH ST E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-2229
Practice Address - Country:US
Practice Address - Phone:941-747-8968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISE HOME COMPANIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231014302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid