Provider Demographics
NPI:1013347947
Name:PRECIOUS CARE AT HOME SERVICES INC
Entity Type:Organization
Organization Name:PRECIOUS CARE AT HOME SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:NAILEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-425-2273
Mailing Address - Street 1:9401 MATHY DR STE 350
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5333
Mailing Address - Country:US
Mailing Address - Phone:703-425-2273
Mailing Address - Fax:703-425-2274
Practice Address - Street 1:1735 MARKET ST
Practice Address - Street 2:SUITE 3750
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-7501
Practice Address - Country:US
Practice Address - Phone:267-507-6156
Practice Address - Fax:267-507-6150
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECIOUS CARE AT HOME SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-14403251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215964200Medicaid