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PROVIDENCE SERVICE, LLC
NPI 1245593268
Clinic/Center in Queen Creek, AZ

Active since June 25, 2012
2530 W ALLENS PEAK DR, QUEEN CREEK, AZ 85142(615) 668-4485(480) 812-3131 Get Directions Write a Review

NPPES record last updated: November 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Service, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE SERVICE, LLC (NPI 1245593268) is a healthcare organization registered as a clinic/center in Queen Creek, Arizona and active in the NPI registry since June 2012. The organization lists Olayinka O Osinloye, Fnp/pmhnp, as its authorized official.

NPPES Registry Identity

NPI1245593268
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROVIDENCE SERVICE, LLC
Location Address2530 W ALLENS PEAK DRQueen Creek, AZ 85142-4642
Mailing Address2530 W Allens Peak DrQueen Creek, AZ 85142-4642 · (615) 668-4485 · Fax (480) 812-3133
Phone(615) 668-4485
Fax(480) 812-3131
Organization SubpartNo
Authorized OfficialOlayinka O OsinloyeFnp/pmhnp · (615) 668-4485
Enumeration DateJune 25, 2012
Last NPPES UpdateNovember 22, 2022
NPPES CertifiedNovember 22, 2022
✔ NPI 1245593268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in TN · APN0000015886
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
2530 W ALLENS PEAK DR, Queen Creek, AZ 85142
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Other Names 1

Doing Business AsProvidence Service, Llc

Other Identifiers 2

Medicaid1524996TN
MedicaidZ181765AZ

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Service, LLC's NPI number?

The NPI number for Providence Service, LLC is 1245593268. It was assigned to this organization in the NPPES registry on June 25, 2012.

Where is Providence Service, LLC located?

Providence Service, LLC is located at 2530 W Allens Peak Dr, Queen Creek, AZ 85142. The listed phone number is (615) 668-4485.

What is Providence Service, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Providence Service, LLC was last updated on November 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.