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Organization
PROVIDENT CARE
Active
Organization
PROVIDENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN D CONLEY RN (CEO)
(209) 578-1210
Entity
Organization
Contact information
Practice address
100 SYCAMORE AVE, MODESTO, CA 95354-0500
(209) 578-1210
Mailing address
PO BOX 3558, MODESTO, CA 95352-3558
(209) 578-1210
(209) 549-9364
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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