Provider Demographics
NPI:1811171846
Name:PRECIOUS CARE HOME CARE AGENCY
Entity type:Organization
Organization Name:PRECIOUS CARE HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-693-7017
Mailing Address - Street 1:125 MAIN ST
Mailing Address - Street 2:OFFICE 5&6
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3318
Mailing Address - Country:US
Mailing Address - Phone:919-693-7017
Mailing Address - Fax:919-693-1318
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:OFFICE 5&6
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3318
Practice Address - Country:US
Practice Address - Phone:919-693-7017
Practice Address - Fax:919-693-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3612251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418447Medicaid