| NPI | 1881681518 |
|---|---|
| Doing Business As | PROVIDENCE ELDERPLACE |
| Entity Type | Organization |
| Authorized Contact | ELLEN GARCIA Executive Director 206-320-5325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2008-09-29 |