Provider Demographics
NPI:1316285620
Name:PROVIDENCE HEALTH, LLC
Entity type:Organization
Organization Name:PROVIDENCE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCESCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:954-857-7430
Mailing Address - Street 1:43 S POMPANO PKWY
Mailing Address - Street 2:#305
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3001
Mailing Address - Country:US
Mailing Address - Phone:954-857-7430
Mailing Address - Fax:
Practice Address - Street 1:43 S POMPANO PKWY
Practice Address - Street 2:#305
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3001
Practice Address - Country:US
Practice Address - Phone:954-857-7430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT1092251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health