Organization
PROVIDENT SENIOR SOLUTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN D CONLEY RN (PRESIDENT/CEO)
(209) 578-1210
Entity
Organization
Contact information
Practice address
1025 14TH ST, MODESTO, CA 95354, MODESTO, CA 95354-9535
(209) 595-4421
Mailing address
PO BOX 3558, MODESTO, CA 95352-3558
(120) 957-8121
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
05/20/2022
Last updated
08/01/2022
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