Provider Demographics
NPI:1124273800
Name:PRECIOUS LINK HOMEHEALTH
Entity type:Organization
Organization Name:PRECIOUS LINK HOMEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADETULA
Authorized Official - Suffix:
Authorized Official - Credentials:ND, RPH
Authorized Official - Phone:972-572-9998
Mailing Address - Street 1:1005 YORK DR
Mailing Address - Street 2:SUITE 105A
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2083
Mailing Address - Country:US
Mailing Address - Phone:972-572-9998
Mailing Address - Fax:972-572-9990
Practice Address - Street 1:1005 YORK DR
Practice Address - Street 2:SUITE 105A
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2083
Practice Address - Country:US
Practice Address - Phone:972-572-9998
Practice Address - Fax:972-572-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness