Provider Demographics
NPI:1194901496
Name:PRECIOUS CARE AT HOME SERVICES INC
Entity type:Organization
Organization Name:PRECIOUS CARE AT HOME SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NAILEY
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-425-2273
Mailing Address - Street 1:9401 MATHY DRIVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5333
Mailing Address - Country:US
Mailing Address - Phone:703-425-2273
Mailing Address - Fax:703-425-2274
Practice Address - Street 1:9401 MATHY DR
Practice Address - Street 2:SUITE 350
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5310
Practice Address - Country:US
Practice Address - Phone:703-425-2273
Practice Address - Fax:703-425-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-08403251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215964200Medicaid