Provider Demographics
NPI:1568136364
Name:PRECIOUS MOMENTS HOME CARE LLC
Entity Type:Organization
Organization Name:PRECIOUS MOMENTS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-784-4760
Mailing Address - Street 1:5002 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3508
Mailing Address - Country:US
Mailing Address - Phone:267-784-4760
Mailing Address - Fax:
Practice Address - Street 1:5002 N 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3508
Practice Address - Country:US
Practice Address - Phone:267-784-4760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health