| NPI | 1003892092 |
|---|---|
| Former Legal Business Name | PROVIDENCE-PROVIDENCE PARK HOSPITAL |
| Entity Type | Organization |
| Authorized Contact | JOSEPH HURSHE President 243-349-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273R00000X Psychiatric Unit |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2022-06-28 |