| Providence Healthcare Services Pllc | |
|
404 Fairly St # A Laurinburg NC 28352-3612 | |
| (910) 318-4958 | |
| Not Available |
| Full Name | Providence Healthcare Services Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 404 Fairly St # A, Laurinburg, North Carolina |
| Authorized Official Name and Position | Lucy Kenya-tolo (OWNER) |
| Authorized Official Contact | 9103184958 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Healthcare Services Pllc 404 Fairly St # A Laurinburg NC 28352-3612 Ph: (910) 318-4958 | Providence Healthcare Services Pllc 404 Fairly St # A Laurinburg NC 28352-3612 Ph: (910) 318-4958 |
| NPI Number | 1881379832 |
|---|---|
| Provider Enumeration Date | 06/19/2023 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881379832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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