| NPI | 1255530465 |
|---|---|
| Doing Business As | PROVIDENTCARE |
| Entity Type | Organization |
| Authorized Contact | DAN FRIEDMAN Officer 314-351-3510 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: MO 00478801) |
| Additional Taxonomies | 251F00000X Home Infusion (Licence: MO 00478801) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2008-07-01 |