Provider Demographics
NPI:1366032716
Name:PROVIDE A CARE INC
Entity Type:Organization
Organization Name:PROVIDE A CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-706-3936
Mailing Address - Street 1:15028 OLD LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44618-9731
Mailing Address - Country:US
Mailing Address - Phone:330-828-2278
Mailing Address - Fax:
Practice Address - Street 1:15028 OLD LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:OH
Practice Address - Zip Code:44618-9731
Practice Address - Country:US
Practice Address - Phone:330-828-2278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0800ROtherLICENSURE