Provider Demographics
NPI:1942830724
Name:PRECIOUS KEEPERS
Entity Type:Organization
Organization Name:PRECIOUS KEEPERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANALEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-546-1483
Mailing Address - Street 1:205 SOUTH AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4823
Mailing Address - Country:US
Mailing Address - Phone:845-518-8164
Mailing Address - Fax:
Practice Address - Street 1:205 SOUTH AVE STE 108
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4823
Practice Address - Country:US
Practice Address - Phone:845-518-8164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization