| NPI | 1396096996 |
|---|---|
| Doing Business As | PROVIDENCE EXTENDED CARE |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2021-11-03 |