| NPI | 1063780674 |
|---|---|
| Other Name | PROVIDENCE HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | CHARLES F HABERKERN VP 202-854-4255 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: DC HFD01-0212) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: DC HFD01-0212) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2016-09-06 |