Organization
AT EASE HOME CARE, INC.
Active
Parent organization
PROVIDENT, INC.
Other names
ProvidentCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENT, INC.
Authorized official
DAN FRIEDMAN (OFFICER)
(314) 351-3510
Entity
Organization
Contact information
Practice address
11500 OLIVE BLVD, SUITE 176, SAINT LOUIS, MO 63141-7143
(314) 531-5310
Mailing address
11500 OLIVE BLVD, SUITE 176, SAINT LOUIS, MO 63141-7143
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
00478801
MO
251F00000X
Home Infusion Agency
00478801
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265298901
—
MO
05
—
285298907
—
MO
Enumeration date
07/17/2007
Last updated
07/01/2008
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