Provider Demographics
NPI:1932935459
Name:PROVIDIA HOME CARE LLC.
Entity type:Organization
Organization Name:PROVIDIA HOME CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-464-2284
Mailing Address - Street 1:3661 CORTEZ RD W STE 100
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3230
Mailing Address - Country:US
Mailing Address - Phone:813-540-3300
Mailing Address - Fax:813-540-4400
Practice Address - Street 1:3661 CORTEZ RD W STE 100
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3230
Practice Address - Country:US
Practice Address - Phone:813-540-3300
Practice Address - Fax:813-540-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health