| NPI | 1215952411 |
|---|---|
| Doing Business As | PROVIDENCE MEMORIAL HOSPITAL |
| Entity Type | Organization |
| Authorized Contact | VICTORIA GONZALEZ CFO 915-577-6625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 000130) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-05-03 |