# PROVIDENCE HOME CARE LLC

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

## Provider details

- **NPI number:** 1649630732
- **Authorized official:** MR. MOHAMED ELKOMY (BUSINESS MANAGER)
- **Authorized official phone:** (573) 442-5950

## Contact information

- **Practice address:** 2400 E BUSINESS LOOP 70, COLUMBIA, MO 65201-5510
- **Practice address phone:** (573) 442-5950
- **Practice address fax:** (573) 442-5386
- **Mailing address:** 2400 E BUSINESS LOOP 70, COLUMBIA, MO 65201-5510
- **Mailing address phone:** (573) 442-5950
- **Mailing address fax:** (573) 442-5386

## Taxonomy

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

## Other

- **Enumeration date:** 03/02/2016
- **Last updated:** 12/29/2021