| Providence Home Care L.l.c | |
|
3965 4th St E West Fargo ND 58078-2865 | |
| (701) 709-0799 | |
| Not Available |
| Full Name | Providence Home Care L.l.c |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 3965 4th St E, West Fargo, North Dakota |
| Authorized Official Name and Position | Kojo Alexander (C.F.O) |
| Authorized Official Contact | 7017090799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Home Care L.l.c 3965 4th St E West Fargo ND 58078-2865 Ph: (701) 709-0799 | Providence Home Care L.l.c 3965 4th St E West Fargo ND 58078-2865 Ph: (701) 709-0799 |
| NPI Number | 1861006439 |
|---|---|
| Provider Enumeration Date | 09/01/2020 |
| Last Update Date | 02/24/2022 |
| Certification Date | 02/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861006439 | NPI | - | NPPES |
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