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Organization
PROVIDENCE GROUP HOME
Active
Organization
PROVIDENCE GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. POLYCARP ANAYO OHAKWE (OWNER)
(214) 680-9144
Entity
Organization
Contact information
Practice address
1047 HILLBURN DR, DALLAS, TX 75217-4328
(214) 680-9144
(972) 226-7935
Mailing address
3327 CHAPELWOOD DR, SUNNYVALE, TX 75182-4005
(214) 680-9144
(972) 226-7935
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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