| NPI | 1750763975 |
|---|---|
| Former Legal Business Name | PROVIDENT SERVICES CORP. |
| Entity Type | Organization |
| Authorized Contact | CELESTE GRAHAM Regional Director 504-455-2446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: LA 108595) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |