Providence Health Care Agency LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROVIDENCE HEALTH CARE AGENCY LLC

Practice address

2538 Bahama Dr Apt 238
Dallas, TX 75211-2137

Phone

(214) 407-4242

NPI assigned

Aug 23, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Quargnilde Ilekendi

Title

Member

Phone

(214) 407-4242

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1003649104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2538 BAHAMA DR APT 238",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752112137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2538 BAHAMA DR APT 238",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752112137",
            "telephone_number": "214-407-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "ILEKENDI",
        "authorized_official_first_name": "QUARGNILDE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "214-407-4242"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyra Prout, NP-C
• Claire Provenzano, PA-C
• Providence Anesthesia Services PLLC
• Providence Drugs LLC
• Providence Group Home
• Providence Home Care LLC
• Providence Senior Services, LLC (Always Best Care Senior Services)
• Tiffany Overstreet Providence, DO
• Provident Medical Center (Clinic)
• Providers Association for Home Health,Hospice& Healthcare Agencies Inc (Hospe for the Hopeless Hospice INC)

• In Home Supportive Care Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.