Organization
PROVIDENTIAL SOLUTIONS, LLC
Active
Other names
PROVIDENTIAL HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUKE ATANO OSIMA (ADMINISTRATOR)
(410) 998-9978
Entity
Organization
Contact information
Practice address
1 RIDER MILL CT, OWINGS MILLS, MD 21117-2472
(410) 998-9978
(443) 381-0483
Mailing address
1 RIDER MILL CT, OWINGS MILLS, MD 21117-2472
(410) 998-9978
(443) 381-0483
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
R2235
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5709600300
—
MD
Enumeration date
10/09/2017
Last updated
10/09/2017
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