# PROVIDENTIAL HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649136201
- **Authorized official:** EUGENIA MARY TWUMWAA RN (ADMINISTRATOR/CEO)
- **Authorized official phone:** (513) 365-0882

## Contact information

- **Practice address:** 2840 MACK RD, FAIRFIELD, OH 45014-5130
- **Practice address phone:** (513) 365-0882
- **Mailing address:** 2840 MACK RD, FAIRFIELD, OH 45014-5130
- **Mailing address phone:** (513) 365-0882

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 12/29/2025
- **Last updated:** 12/29/2025