Organization
PROVIDENCE CARE
Active
Other names
Providence Care
Organization subpart
No
Provider details
NPI number
Authorized official
DIAMOND WHITE (OWNER)
(404) 974-9744
Entity
Organization
Contact information
Practice address
4062 PEACHTREE RD NE STE 112, BROOKHAVEN, GA 30319-3021
(404) 974-9744
Mailing address
4062 PEACHTREE RD NE STE 112, BROOKHAVEN, GA 30319-3021
(404) 974-9744
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/31/2023
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