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Organization

PROVIDENCE HOME CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRISTOPHER EDWARDS (CHIEF EXECUTIVE OFFICER)
(405) 602-3295
Entity
Organization

Contact information

Practice address
4334 NW EXPRESSWAY, SUITE 176, OKLAHOMA CITY, OK 73116-1578
(405) 602-3295
Mailing address
4334 NW EXPRESSWAY, SUITE 176, OKLAHOMA CITY, OK 73116-1578
(405) 602-3295

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
OK

Other

Enumeration date
09/01/2010
Last updated
09/01/2010
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