Provident Health Care Inc

NPI 1275879801 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1275879801
Enumeration Date 12/31/2012
Last Updated 12/31/2012
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name JERRY R. JERRY
Position OWNER/LICENSEE
Phone (209) 357-2212
Fax (209) 557-5689
Practice Location
1553 TAMARACK AVE
ATWATER CA, 95301-2743, US
Phone (209) 357-2212
Fax (209) 557-5689
Business Location
1238 CATALINA DR
MERCED CA, 95348-9515, US
Phone (209) 723-4888
Fax (209) 722-7087
Toxanomy
Taxonomy Code 315P00000X
License State
License Number
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According to our database, Provident Health Care Inc NPI is 1275879801, taxonomy code is 315P00000X Provident Health Care Inc physically located at 1553 Tamarack Ave, Atwater CA, 95301-2743. NPI Number 1033115704 has the healthcare provider type.

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1275879801 NPI number is provided on an as is basis without warranty of any kind. 1275879801 is maintained by the National Plan & Provider Enumeration System. The contents of Provident Health Care Inc are for informational purposes only.