Organization
PROVIDENT HOME HEALTHCARE, LLC
Active
Parent organization
PROVIDENT GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENT GROUP, INC.
Authorized official
RAMONA ERICKSON (ADMINISTRATOR)
(612) 238-4688
Entity
Organization
Contact information
Practice address
2852 ANTHONY LN S, ST ANTHONY, MN 55418-3233
(612) 238-4688
(612) 238-4689
Mailing address
2852 ANTHONY LN S, ST ANTHONY, MN 55418-3233
(612) 238-4688
(612) 238-4689
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
346508
MN
Other
Enumeration date
10/13/2009
Last updated
12/01/2022
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