Provident
Preferred Provider Organization in Arnold, MO. Organization (NPI-2).
NPI number1316005473
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1316005473
- Entity type
- Organization (NPI-2)
- Legal business name
- Provident
- Organization subpart
- No
- Enumeration date
- Dec 4, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | sw002589 | MO | Yes |
| 251G00000X | Hospice Care, Community Based | 002589 | MO |
Practice location
3675 W Outer Rd203
Arnold, MO 63010-5232
Phone 314-898-0102 · Fax 636-296-3249
Mailing address
3675 W Outer Rd203
Arnold, MO 63010-5232
Phone 314-898-0102 · Fax 636-296-3249
Authorized official
Kristin Bulin
Director Of Counseling Division
3143716500
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