Organization
PROVIDENCE CARE INC
Active
Organization
PROVIDENCE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUILLAUME SERY KABERT (OWNER/CEO)
(301) 277-4337
Entity
Organization
Contact information
Practice address
5711 SARVIS AVE STE 608, RIVERDALE, MD 20737-1394
(301) 277-4337
Mailing address
5711 SARVIS AVE STE 608, RIVERDALE, MD 20737-1394
(301) 277-4337
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
039714600
DC
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245376375
—
VA
05
—
405870400
—
MD
Enumeration date
01/29/2007
Last updated
11/26/2019
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