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Organization
PROVIDENT CARE LLC
Active
Organization
PROVIDENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIVEN KONGLIM (C.E.O)
(614) 893-1535
Entity
Organization
Contact information
Practice address
1415 E DUBLIN GRANVILLE RD STE 201, COLUMBUS, OH 43229-3311
(614) 893-1535
Mailing address
1415 E DUBLIN GRANVILLE RD STE 201, COLUMBUS, OH 43229-3311
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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