Provider Demographics
NPI:1255127627
Name:SIMPLY PRECIOUS CARE LLC
Entity type:Organization
Organization Name:SIMPLY PRECIOUS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CEQUELLA
Authorized Official - Middle Name:SHAMPREE
Authorized Official - Last Name:WHITT
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:317-444-1675
Mailing Address - Street 1:3525 LAKE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-5573
Mailing Address - Country:US
Mailing Address - Phone:317-444-1675
Mailing Address - Fax:
Practice Address - Street 1:3525 LAKE AVE STE 5
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5573
Practice Address - Country:US
Practice Address - Phone:317-444-1675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty