Provider Demographics
NPI:1699236737
Name:PRECIOUS PARTNERS HOMECARE LLC
Entity type:Organization
Organization Name:PRECIOUS PARTNERS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FAIMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOFANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-420-3736
Mailing Address - Street 1:2340 132ND LN NW
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-2570
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2340 132ND LN NW
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55448-2570
Practice Address - Country:US
Practice Address - Phone:763-447-5873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health