| NPI | 1184803280 |
|---|---|
| Other Name | PROVIDENCE |
| Entity Type | Organization |
| Authorized Contact | SHEARLY CHAMBLESS Program Director 714-399-3480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |