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PROVIDENT CARE RESIDENTIAL HOME LLC
NPI 1578150397
Assisted Living Facility in Saint Cloud, FL

Active since December 28, 2020
4170 MUTTER RD, SAINT CLOUD, FL 34769(407) 556-3406(407) 556-3406 Get Directions Write a Review

NPPES record last updated: December 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Provident Care Residential Home Llc NPPES

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

PROVIDENT CARE RESIDENTIAL HOME LLC (NPI 1578150397), doing business as Provident House, is a healthcare organization registered as an assisted living facility in Saint Cloud, Florida and active in the NPI registry since December 2020. The organization lists Nadine Ellis-mcintyre, Administrator, as its authorized official.

NPPES Registry Identity

NPI1578150397
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePROVIDENT CARE RESIDENTIAL HOME LLC
Location Address4170 MUTTER RDSaint Cloud, FL 34769-6836
Mailing Address4170 Mutter RdSaint Cloud, FL 34769-6836 · (407) 556-3406 · Fax (407) 556-3406
Phone(407) 556-3406
Fax(407) 556-3406
Organization SubpartNo
Authorized OfficialNadine Ellis-mcintyreAdministrator · (321) 443-5470
Enumeration DateDecember 28, 2020
NPPES CertifiedDecember 28, 2020
✔ NPI 1578150397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
4170 MUTTER RD, Saint Cloud, FL 34769
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Other Names 1

Doing Business AsProvident House

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 Provident Care Residential Home LLC's NPI number?

The NPI number for Provident Care Residential Home LLC is 1578150397. It was assigned to this organization in the NPPES registry on December 28, 2020. The provider is doing business as Provident House.

Where is Provident Care Residential Home LLC located?

Provident Care Residential Home LLC is located at 4170 Mutter Rd, Saint Cloud, FL 34769. The listed phone number is (407) 556-3406.

What is Provident Care Residential Home LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Provident Care Residential Home LLC was last updated on December 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.