Provident Health Care INC
NPI #1275879801 in Atwater, California
Provider Information
- NPI Number
- 1275879801
- Entity Type
- Organization
- Organization Name
- Provident Health Care INC
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Dec 31, 2012
- Last Updated
- Dec 31, 2012
Practice Location
- Address
- 1553 TAMARACK AVE
- City
- Atwater
- State
- California
- ZIP Code
- 95301-2743
- Phone
- (209) 357-2212
Authorized Official
- Name
- MR. JERRY R. TIU
- Title
- OWNER/LICENSEE
- Phone
- (209) 723-4888
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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