Providence Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROVIDENCE CARE

Doing business as

Providence Care

Practice address

4062 Peachtree Rd NE Ste 112
Brookhaven, GA 30319-3021

Phone

(404) 974-9744

NPI assigned

Jul 2, 2020

Last updated

Sep 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diamond WhiteNPI 1124678420

Title

Owner

Phone

(404) 974-9744

Specialties & licenses 2

Addresses

Other names 1

• Providence Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diamond White

  • Behavior Analyst
  • Stockbridge, GA
  • NPI 1124678420
  NPD Authorized official

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1245857556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4062 PEACHTREE RD NE STE 112",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193021",
            "telephone_number": "404-974-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4062 PEACHTREE RD NE STE 112",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193021",
            "telephone_number": "404-974-9744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6568 Tara Blvd",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302361228",
            "country_code": "US",
            "telephone_number": "404-974-9744",
            "fax_number": "404-920-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIDENCE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DIAMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-974-9744"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.