Provider Demographics
NPI:1699161604
Name:PRECIOUS CARE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:PRECIOUS CARE HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-960-0836
Mailing Address - Street 1:3730 ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1078
Mailing Address - Country:US
Mailing Address - Phone:708-960-0836
Mailing Address - Fax:708-960-0836
Practice Address - Street 1:3730 ASPEN ST
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1078
Practice Address - Country:US
Practice Address - Phone:708-960-0836
Practice Address - Fax:708-960-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health