# PROVIDENCE PROFESSIONAL SERVICES, LLC

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

## Provider details

- **NPI number:** 1851439095
- **Authorized official:** SANDRA FINE (OWNER)
- **Authorized official phone:** (620) 275-7100

## Contact information

- **Practice address:** 302 FLEMING ST, SUITE \#8, GARDEN CITY, KS 67846-6162
- **Practice address phone:** (620) 275-7100
- **Practice address fax:** (620) 275-7116
- **Mailing address:** 302 FLEMING ST, SUITE \#8, GARDEN CITY, KS 67846-6162
- **Mailing address phone:** (620) 275-7100
- **Mailing address fax:** (620) 275-7116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | KS | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 08/22/2020