Provider Demographics
NPI:1528550019
Name:A PRECIOUS HOME CARE SOLUTION CDS LLC
Entity Type:Organization
Organization Name:A PRECIOUS HOME CARE SOLUTION CDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MRS
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-332-5131
Mailing Address - Street 1:2367 PERIWINKLE COURT
Mailing Address - Street 2:
Mailing Address - City:FLORISANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031
Mailing Address - Country:US
Mailing Address - Phone:314-332-5131
Mailing Address - Fax:
Practice Address - Street 1:2367 PERIWINKLE COURT
Practice Address - Street 2:
Practice Address - City:FLORISANT
Practice Address - State:MO
Practice Address - Zip Code:63031
Practice Address - Country:US
Practice Address - Phone:314-332-5131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========Medicaid