| NPI | 1588157341 |
|---|---|
| Doing Business As | PROVIDENT VILLAGE AT CANTON |
| Entity Type | Organization |
| Authorized Contact | DEBRA W. LOCKWOOD President & Chief Financial Officer 225-766-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |