Provider Demographics
NPI:1386467991
Name:PRECISION HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:PRECISION HEALTHCARE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEJAVU
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:980-229-8706
Mailing Address - Street 1:116 WILBY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-2718
Mailing Address - Country:US
Mailing Address - Phone:980-229-8706
Mailing Address - Fax:
Practice Address - Street 1:116 WILBY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-2718
Practice Address - Country:US
Practice Address - Phone:910-309-0543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care