| NPI | 1639624364 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DOAN Chief Compliance Counsel 909-235-4307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KS N105013) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |