# PROVIDER HOME CARE

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

## Provider details

- **NPI number:** 1720834195
- **Authorized official:** ENOCH NWEYADA MR. ENOCH NWEYADA (OWNER)
- **Authorized official phone:** (701) 202-8033

## Contact information

- **Practice address:** 114 E INDIANA AVE, BISMARCK, ND 58504-5769
- **Practice address phone:** (701) 202-8033
- **Mailing address:** 114 E INDIANA AVE, BISMARCK, ND 58504-5769
- **Mailing address phone:** (701) 202-8033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/26/2024
- **Last updated:** 05/15/2024