Organization
PROVIDENTIAL CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA SPENCER (CEO)
(757) 333-2145
Entity
Organization
Contact information
Practice address
3214 ACADEMY AVE, PORTSMOUTH, VA 23703-3203
(757) 333-2145
(757) 802-3565
Mailing address
315 TAFT DR, PORTSMOUTH, VA 23701-4244
(757) 333-2145
(757) 802-3565
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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