Organization
PROVIDENCE TOTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMOTOPE ALEXANDER (ADMINISTRATOR)
(832) 857-0892
Entity
Organization
Contact information
Practice address
10101 HARWIN DR STE 375, HOUSTON, TX 77036-1654
(832) 857-8920
(832) 416-1502
Mailing address
10101 HARWIN DR STE 375, HOUSTON, TX 77036-1654
(832) 857-8920
(832) 416-1502
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/04/2020
Last updated
06/17/2024
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