Organization Active NPI

Precious Pals Inc

  • Counselor
  • South Bend, IN
National Provider Identifier
1760909840
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
PRECIOUS PALS INC
Practice address
1139 E Lasalle Ave
South Bend, IN 46617-3321
Phone
(574) 386-9757
Fax
(574) 246-9578
NPI assigned
Aug 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tina Renee Bynum, B.A., A.A.
Title
Program Director / Counselor
Phone
(574) 386-9757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

1139 E Lasalle Ave
South Bend, IN 46617-3321

Mailing address

1139 E Lasalle Ave
South Bend, IN 46617-3321
Phone (574) 386-9757

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760909840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173321",
            "telephone_number": "574-386-9757",
            "fax_number": "574-246-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173321",
            "telephone_number": "574-386-9757",
            "fax_number": "574-246-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECIOUS PALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR / COUNSELOR",
        "authorized_official_telephone_number": "574-386-9757",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.A., A.A."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.