| Provident Health Care Llc | |
|
314 Main St Uppr Level Greenwood SC 29646-2758 | |
| (252) 955-2354 | |
| (336) 232-1516 |
| Full Name | Provident Health Care Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 314 Main St Uppr Level, Greenwood, South Carolina |
| Authorized Official Name and Position | Roberta Denise Brinkley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2529552354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provident Health Care Llc Po Box 16066 High Point NC 27261-6066 Ph: (252) 955-2354 | Provident Health Care Llc 314 Main St Uppr Level Greenwood SC 29646-2758 Ph: (252) 955-2354 |
| NPI Number | 1871334227 |
|---|---|
| Provider Enumeration Date | 05/31/2024 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871334227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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