Providence Park, Inc. in Waco - Nursing Facility/intermediate Care Facility

Providence Park, Inc. - NPI 1720086655

Providence Park, Inc. is a Nursing Facility/intermediate Care Facility in Waco, Texas. Providence Park, Inc. practices all healthcare services and medical treatments related to Nursing Facility/intermediate Care Facility. The NPI Number for Providence Park, Inc. is 1720086655. The last update date is 2016-01-28.

Providence Park, Inc.'s current location address is 300 W Highway 6, Waco, Texas. You can contact this provider via phone number 2547618500 and fax number 2547618050. The mailing address for Providence Park, Inc. is 300 W Highway 6, Waco, Texas. To know further, please read the information below!

Provider Profile Detail

Provider Organization Providence Park, Inc.
Address 300 W Highway 6, Waco, Texas
Phone Number 2547618500
Fax Number 2547618050
Sole Proprietor --
Credentials --

Authorized Official

Title or Position ADMINISTRA
Authorized Official Name Sonnier L Amanda
Credentials LNFA
Telephone Number 2547618500

NPI Number Detail

NPI Number 1720086655
Provider Enumeration Date 2005-07-13
Last Updated Date 2016-01-28

Provider Mailing Address Detail

Address 300 W Highway 6
City Waco
State Texas (TX)
Post Code 767124041
Phone Number 2547618500
Fax Number 2547618050

Provider's Primary Taxonomy Detail

Speciality Nursing Facility/intermediate Care Facility
Taxonomy 313M00000X
Licence No 108085
Definition:
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the reha

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
530801 TX --
1026977 TX --
HH2907 BLUE CROSS BLUE SHIELD

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FAQs about Providence Park, Inc.

What is the unique 10-digit identification code issued to Providence Park, Inc. by the Centers for Medicare & Medicaid Services?

The Providence Park, Inc. has been assigned the NPI (National Provider Identifier) 1720086655 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.

Could you please share the complete physical location address where Providence Park, Inc.'s facilities are situated?

The facilities of Providence Park, Inc. are physically located at the following address: 300 W Highway 6, Waco, TX, 767124041.

What is Providence Park, Inc.'s area of expertise and its corresponding taxonomy classification?

The Providence Park, Inc.'s field of specialization is Nursing Facility/intermediate Care Facility, and it falls under the taxonomy code 313M00000X, which categorizes healthcare providers based on their areas of practice.

On what date did the Providence Park, Inc. receive the assignment of its 1720086655 from the Centers for Medicare & Medicaid Services?

The Providence Park, Inc. was issued its 1720086655 by the Centers for Medicare & Medicaid Services on 2005-07-13.

When was the information pertaining to Providence Park, Inc. most recently updated or revised?

The details related to Providence Park, Inc., including its address, specialty, and other relevant information, were last updated or revised on 2016-01-28.

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