Provider Demographics
NPI:1174162408
Name:PRECIOUS GEMS HOMES
Entity type:Organization
Organization Name:PRECIOUS GEMS HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYREETA
Authorized Official - Middle Name:
Authorized Official - Last Name:DWEH-CHENNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-361-4056
Mailing Address - Street 1:512 S HORSESHOE BND
Mailing Address - Street 2:
Mailing Address - City:MAIZE
Mailing Address - State:KS
Mailing Address - Zip Code:67101-7012
Mailing Address - Country:US
Mailing Address - Phone:316-977-8875
Mailing Address - Fax:316-977-8870
Practice Address - Street 1:512 S HORSESHOE BND
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-7012
Practice Address - Country:US
Practice Address - Phone:316-977-8875
Practice Address - Fax:316-977-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility