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Organization
PROVIDENTIAL HEALTH CARE, INC
Active
Organization
PROVIDENTIAL HEALTH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA FLORENCE MWESIGWA RN (ADMINISTRATOR)
(214) 240-6146
Entity
Organization
Contact information
Practice address
13400 SUTTON PARK DR S, SUITE 1101, JACKSONVILLE, FL 32224-0236
(904) 992-2273
(904) 992-2270
Mailing address
13400 SUTTON PARK DR S, SUITE 1101, JACKSONVILLE, FL 32224-0236
(904) 992-2273
(904) 992-2270
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/15/2010
Last updated
08/10/2010
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