Provider Demographics
NPI:1831730977
Name:PRECIOUS ANGELS HOME CARE
Entity type:Organization
Organization Name:PRECIOUS ANGELS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-494-1980
Mailing Address - Street 1:3765 DEER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-5219
Mailing Address - Country:US
Mailing Address - Phone:901-494-1980
Mailing Address - Fax:901-367-2716
Practice Address - Street 1:3765 DEER FOREST DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-5219
Practice Address - Country:US
Practice Address - Phone:901-573-3675
Practice Address - Fax:901-367-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health