Providence Community Services

NPI #1801920319 in Lemon Grove, California

Provider Information

NPI Number: 1801920319
Entity Type: Organization
Organization Name: Providence Community Services
Primary Specialty: Case Management
Enumeration Date: Mar 15, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 3240 OLIVE ST
Address 2: APARTMENT #50
City: Lemon Grove
State: California
ZIP Code: 91945-1768
Phone: (619) 248-3835

Authorized Official

Name: MR. JAMAL LEO ST.CYR, B.A.
Title: CASE MANAGER
Phone: (858) 300-0460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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