Organization
1ST PROVIDENCE HOME CARE, LLC
Active
Other names
1st PROVIDENCE HOME CARE, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EMELIA KORKOR (CEO)
(571) 334-0571
Entity
Organization
Contact information
Practice address
3368 LOGSTONE DR, TRIANGLE, VA 22172-2053
(571) 334-0571
Mailing address
3368 LOGSTONE DR, TRIANGLE, VA 22172-2053
(571) 334-0571
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
11/10/2023
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