PROVIDENT FOUNDATION - WEDGEWOOD TERRACE LLC

LEWISTON, ID
NPI1295228054
Entity TypeOrganization
Authorized ContactDEBRA W. LOCKWOOD
President & Chief Financial Officer
225-766-3977
Organization Subpart ?No
Primary Taxonomy310400000X Assisted Living Facility
Additional Taxonomies311500000X Alzheimer Center (Dementia Center)
385H00000X Respite Care
Enumeration Date2018-06-07
Last Update Date2018-06-07
Business Address
PROVIDENT FOUNDATION - WEDGEWOOD TERRACE LLC
2114 VINEYARD AVENUE
LEWISTON, ID 83501
Phone number: 208-743-4545
Mailing Address
PROVIDENT FOUNDATION - WEDGEWOOD TERRACE LLC
5565 BANKERS AVENUE
BATON ROUGE, LA 70808
Phone number: 225-766-3977