Provider Demographics
NPI:1427459791
Name:PRECIOUS MOMENTS SENIOR HOME CARELLC
Entity type:Organization
Organization Name:PRECIOUS MOMENTS SENIOR HOME CARELLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KRESGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-835-7845
Mailing Address - Street 1:8 VANNATTA ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1921
Mailing Address - Country:US
Mailing Address - Phone:908-835-7845
Mailing Address - Fax:908-835-7846
Practice Address - Street 1:8 VANNATTA ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1921
Practice Address - Country:US
Practice Address - Phone:908-835-7845
Practice Address - Fax:908-835-7846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care