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Organization
PROVIDENCE HOME CARE LLC
Active
Organization
PROVIDENCE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERTHIA MCCULLOUGH (OWNER)
(864) 252-9022
Entity
Organization
Contact information
Practice address
128 MILLPORT CIR, SUITE 200, GREENVILLE, SC 29607-5571
(864) 252-9022
Mailing address
128 MILLPORT CIR, SUITE 200, GREENVILLE, SC 29607-5571
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/03/2013
Last updated
07/02/2014
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