Organization
PROVIDENCE SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREEANN HOERNING (AR BILLING MANAGER)
(520) 747-6691
Entity
Organization
Contact information
Practice address
301 N HIGH ST, ANTLERS, OK 74523-2238
(580) 298-5779
(580) 298-6699
Mailing address
620 N CRAYCROFT RD, TUCSON, AZ 85711-1448
(520) 747-6694
(520) 747-6613
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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