| Organization Name: | PROVIDENDCE SENIOR CARE |
| NPI Number: | 1619283249 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DORINDA JEAN SOHMER (AGENCY DIRECTOR) |
| Mailing Address: | 1120 Randolph St Ste 42 Thomasville |
| State: | NC US |
| Postal Code: | 273605759 |
| Phone Number: | 3364723810 |
| Fax Number: | 3367436335 |
| NPI Enumeration Date: | 08/20/2010 |
| NPI Last Update Date: | 08/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | HC4146 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |