| NPI | 1821019514 |
|---|---|
| Doing Business As | PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2021-04-01 |