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1811219942
PROVIDENCE GROUP HOME
DALLAS, TX
NPI
1811219942
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Entity Type
Organization
Authorized Contact
POLYCARP ANAYO OHAKWE
Owner
214-680-9144
Organization Subpart ?
No
Primary Taxonomy
251E00000X Home Health
Enumeration Date
2010-02-16
Last Update Date
2010-02-16
Business Address
PROVIDENCE GROUP HOME
1047 HILLBURN DR
DALLAS, TX 75217-4328
Phone number: 214-680-9144
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Mailing Address
PROVIDENCE GROUP HOME
3327 CHAPELWOOD DR
SUNNYVALE, TX 75182-4005
Phone number: 214-680-9144
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