Organization
PROVIDENCE SERVICE, LLC
Active
Organization
PROVIDENCE SERVICE, LLC
Active
Other names
Providence Service, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLAYINKA O OSINLOYE NP (FNP/PMHNP)
(615) 668-4485
Entity
Organization
Contact information
Practice address
2530 W ALLENS PEAK DR, QUEEN CREEK, AZ 85142-4642
(615) 668-4485
(480) 812-3131
Mailing address
2530 W ALLENS PEAK DR, QUEEN CREEK, AZ 85142-4642
(615) 668-4485
(480) 812-3133
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
APN0000015886
TN
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1524996
—
TN
05
—
Z181765
—
AZ
Enumeration date
06/25/2012
Last updated
11/22/2022
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