Providence Park, Inc. in Waco - Skilled Nursing Facility
Providence Park, Inc. - NPI 1720086655
Providence Park, Inc. is a Skilled Nursing Facility in Waco, Texas. Providence Park, Inc. practices all healthcare services and medical treatments related to Skilled Nursing 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 | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | 108085 |
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Definition: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring serv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 530801 | TX | -- | |
| 1026977 | TX | -- | |
| HH2907 | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
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 Skilled Nursing Facility, and it falls under the taxonomy code 314000000X, 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.