| NPI | 1962505354 |
|---|---|
| Other Name | PROVIDENCE HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | KAREN K RICHARDSON Senior VP, CFO 254-751-4146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-02-01 |