Organization
PROVIDENCE HOME CARE L.L.C
Active
Other names
Providence Home Care L.L.C
Organization subpart
No
Provider details
NPI number
Authorized official
KOJO ALEXANDER (C.F.O)
(701) 709-0799
Entity
Organization
Contact information
Practice address
3965 4TH ST E, WEST FARGO, ND 58078-2865
(701) 709-0799
Mailing address
3965 4TH ST E, WEST FARGO, ND 58078-2865
(701) 709-0799
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
163WH0200X
Home Health Registered Nurse
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
09/01/2020
Last updated
02/24/2022
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