Providence Home Care L.L.C

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

PROVIDENCE HOME CARE L.L.C

Doing business as

Providence Home Care L.L.C

Practice address

3965 4TH St E
West Fargo, ND 58078-2865

Phone

(701) 709-0799

NPI assigned

Feb 24, 2022

Organization subpart

No

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

Authorized official

Name

Kojo Alexander

Title

Director of Operations

Phone

(701) 709-0799

Specialties & licenses 5

Addresses

Other names 1

• Providence Home Care L.L.C Doing business as

Tax ID family

Providence Home Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Providence Home Care L.L.C

  • Intellectual & Developmental Disabilities Psychologist
  • West Fargo, ND
  • NPI 1861006439
  NPD tax ID

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1689320988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 4TH ST E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782865",
            "telephone_number": "701-709-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 4TH ST E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782865",
            "telephone_number": "701-709-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOME CARE L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "KOJO",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "701-709-0799"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Home Care L.L.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shainee Price
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• Professional Portable Radiologic Services, Inc.
• Sarah Prom, LPC
• Providence Home Care L.L.C
• Stephani Puckett
• Katharine Rhonda Radermacher, MS,CCC-SLP
• Samjhana Rai
• Lisa Ramstad

• Personal Care Attendant in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Personal Care Attendant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.