Organization
PROVIDENT HOME CARE, INC
Active
Other names
Provident Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS PEREZ-SANTALLA (PRESIDENT)
(908) 264-2641
Entity
Organization
Contact information
Practice address
70 FLORAL AVE, NEW PROVIDENCE, NJ 07974-1511
(908) 264-2641
Mailing address
70 FLORAL AVE, NEW PROVIDENCE, NJ 07974-1511
(908) 264-2641
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HP0184300
NJ
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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