NPI | 1114986924 |
---|---|
Doing Business As | PROVIDENCE HEALTH CARE CENTER |
Entity Type | Organization |
Authorized Contact | DENNIS WEATHERFORD President & CEO 765-655-2620 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
Enumeration Date | 2006-03-21 |
Last Update Date | 2014-11-20 |