Organization
PROVIDENCE HOME CARE L.L.C
Active
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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