Providence Park, Inc.
NPI #1720086655 in Waco, Texas
Provider Information
- NPI Number
- 1720086655
- Entity Type
- Organization
- Organization Name
- Providence Park, Inc.
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 13, 2005
- Last Updated
- Jun 23, 2025
Practice Location
Authorized Official
- Name
- ERIN SHADBOLT
- Title
- CEO
- Phone
- (314) 729-3500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nursing Facility/Intermediate Care Facility |
| Skilled Nursing Facility |
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