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General NPI Number Information
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NPI Number | 1467306118
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Entity Type | Organization
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Legal Business Name | PROVIDENCE CARE GROUP, INC.
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 105 MARKET PLACE SUITE 9, UNIT 5 & 6
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City | GLASSBORO
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State | NJ
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Zip | 08028-2075
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Country | US
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Telephone | 856-888-0454
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Fax |
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Provider Business Mailing Address
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Address Line | 105 MARKET PLACE SUITE 9, UNIT 5 & 6
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City | GLASSBORO
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State | NJ
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Zip | 08028
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Country | US
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Telephone | 856-888-0454
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR OF OPERATIONS
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Name | MRS. MABLE PHILIP
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Credential |
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Telephone | 267-629-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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