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Organization
PROVIDIAN HEALTHCARE LLC
Active
Organization
PROVIDIAN HEALTHCARE LLC
Active
Other names
Tri county healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINA HALL (CEO)
(678) 491-7870
Entity
Organization
Contact information
Practice address
12409 WILLOW FOREST DR, MOORPARK, CA 93021-2763
(678) 491-7870
Mailing address
12409 WILLOW FOREST DR, MOORPARK, CA 93021-2763
(678) 491-7870
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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