Provider Demographics
NPI:1891255378
Name:PRECIOUS JEWELS IN HOME CARE
Entity Type:Organization
Organization Name:PRECIOUS JEWELS IN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-382-1002
Mailing Address - Street 1:PO BOX 6004
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72124-6004
Mailing Address - Country:US
Mailing Address - Phone:870-382-1002
Mailing Address - Fax:870-382-1001
Practice Address - Street 1:124 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:DUMAS
Practice Address - State:AR
Practice Address - Zip Code:71639-2219
Practice Address - Country:US
Practice Address - Phone:870-382-1002
Practice Address - Fax:870-382-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR230292732Medicaid
AR228457797Medicaid
AR230287797Medicaid
AR228291732Medicaid