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Organization
PROVIDENT IN HOME SERVICES, LLC
Active
Organization
PROVIDENT IN HOME SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIGNER SMITH (DIRECTOR)
(314) 736-1919
Entity
Organization
Contact information
Practice address
1515 N WARSON RD STE 241, SAINT LOUIS, MO 63132-1109
(314) 736-1919
(314) 736-1787
Mailing address
1 S FLORISSANT RD, FERGUSON, MO 63135-2333
(314) 736-1919
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
12/09/2020
Last updated
10/04/2023
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