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Contact Information

PROVIDIAN HEALTHCARE LLC
12409 WILLOW FOREST DR
MOORPARK, CA93021-2763
 Phone: 678-491-7870
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
 

Community/Behavioral Health

251S00000X
 

In Home Supportive Care

253Z00000X
 

Nursing Care

251J00000X
Indicates primary specialty

NPI Profile & details for PROVIDIAN HEALTHCARE LLC

NPI Number 1225574734
LBN Legal business name PROVIDIAN HEALTHCARE LLC
Authorized official ELAINA HALL - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/09/2017
Last updated 01/09/2017 - About 9 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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