Provident Foundation - Wedgewood Terrace LLC
NPI #1295228054 in Lewiston, Idaho
Provider Information
- NPI Number
- 1295228054
- Entity Type
- Organization
- Organization Name
- Provident Foundation - Wedgewood Terrace LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jun 7, 2018
- Last Updated
- Jun 7, 2018
Practice Location
Authorized Official
- Name
- DEBRA W. LOCKWOOD
- Title
- PRESIDENT & CHIEF FINANCIAL OFFICER
- Phone
- (225) 766-3977
Specialties & Taxonomy Codes
| Specialty |
|---|
| Alzheimer Center (Dementia Center) |
| Respite Care |
| Assisted Living Facility |
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