Provider Demographics
NPI:1245552629
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:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LE'SHAWN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:RIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-289-1343
Mailing Address - Street 1:22350 TRACY AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-3267
Mailing Address - Country:US
Mailing Address - Phone:216-253-4183
Mailing Address - Fax:
Practice Address - Street 1:22350 TRACY AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-3267
Practice Address - Country:US
Practice Address - Phone:216-253-4183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health