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Organization
PROVIDENT HOME CARE, INC.
Active
Organization
PROVIDENT HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID E WILSON CPA (OWNER/CFO)
(615) 347-0900
Entity
Organization
Contact information
Practice address
4934 17TH AVE N, ST PETERSBURG, FL 33710-5202
(615) 347-0900
Mailing address
123 PEBBLE CREEK RD, FRANKLIN, TN 37064-5525
(615) 347-0900
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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