| NPI | 1245593268 |
|---|---|
| Doing Business As | PROVIDENCE SERVICE, LLC |
| Entity Type | Organization |
| Authorized Contact | OLAYINKA O OSINLOYE Fnp/Pmhnp 615-668-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: TN APN0000015886) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-11-22 |