Organization
PROVIDENT HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E WILSON CPA (OWNER/CFO)
(615) 347-0900
Entity
Organization
Contact information
Practice address
925 S CHURCH ST STE B200, MURFREESBORO, TN 37130-4993
(615) 962-7217
(615) 962-7298
Mailing address
1515 S ATLANTIC AVE APT 204, COCOA BEACH, FL 32931-2374
(615) 347-0900
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
08/09/2024
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