| NPI | 1568103919 |
|---|---|
| Former Legal Business Name | PROVIDENCE PERSONAL CARE PPC |
| Entity Type | Organization |
| Authorized Contact | JULIET DONNA PROVIDENCE CEO/Manager 424-206-0650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-04-07 |