# PROVIDENCE CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245857556
- **Authorized official:** DIAMOND WHITE (OWNER)
- **Authorized official phone:** (404) 974-9744

## Contact information

- **Practice address:** 4062 PEACHTREE RD NE STE 112, BROOKHAVEN, GA 30319-3021
- **Practice address phone:** (404) 974-9744
- **Mailing address:** 4062 PEACHTREE RD NE STE 112, BROOKHAVEN, GA 30319-3021
- **Mailing address phone:** (404) 974-9744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 261QA0600X | Adult Day Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/02/2020
- **Last updated:** 09/29/2026