Provider Demographics
NPI:1356799589
Name:PRECISION HEALTHCARE RESOURCES INC
Entity type:Organization
Organization Name:PRECISION HEALTHCARE RESOURCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:AREBAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-299-5079
Mailing Address - Street 1:4 WEST ROLLING CROSSROAD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-747-4572
Mailing Address - Fax:410-747-4208
Practice Address - Street 1:4 W ROLLING
Practice Address - Street 2:SUITE 13
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:410-299-5079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD524500100Medicaid