# PROVIDENCE HEALTHCARE SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boston Healthcare Alliance
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487272324
- **Authorized official:** KETHY MICHEL (PRESIDENT)
- **Authorized official phone:** (404) 254-7099

## Contact information

- **Practice address:** 1230 PEACHTREE ST NE FL 19, ATLANTA, GA 30309-3574
- **Practice address phone:** (404) 254-7099
- **Practice address fax:** (678) 658-7634
- **Mailing address:** 1230 PEACHTREE ST NE FL 19, ATLANTA, GA 30309-3574
- **Mailing address phone:** (404) 254-7099
- **Mailing address fax:** (678) 658-7634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/07/2020
- **Last updated:** 07/07/2020