Organization
PROVIDENCE HEALTH CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUARGNILDE ILEKENDI (MEMBER)
(214) 407-4242
Entity
Organization
Contact information
Practice address
2538 BAHAMA DR APT 238, DALLAS, TX 75211-2137
(214) 407-4242
Mailing address
2538 BAHAMA DR APT 238, DALLAS, TX 75211-2137
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
08/23/2024
Last updated
01/22/2025
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