Organization
PROVIDENTIAL HOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIANA AMEYAA SARPONG REGISTERED NURSE (DIRECTOR AND ADMINISTRATOR)
(978) 844-6486
Entity
Organization
Contact information
Practice address
1445 E RIO RD STE 201C, CHARLOTTESVILLE, VA 22901-1751
(978) 844-6486
Mailing address
1445 E RIO RD STE 201C, CHARLOTTESVILLE, VA 22901-1751
(978) 844-6486
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
09/29/2019
Last updated
09/29/2019
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