1720086655 PROVIDENCE PARK, INC.
Skilled Nursing Facility
Active
Basic Information
- Organization Name
- PROVIDENCE PARK, INC.
- Enumeration Date
- July 13, 2005
- Last Update
- April 30, 2025
- Authorized Official
- KELLIE GRONEFELD
COO
Phone: (314) 729-3500
Practice Location
- Address
- 300 W HIGHWAY 6
WACO, TX 767124041 - Phone
- (254) 761-8500
- Fax
- (254) 761-8050
Mailing Address
- Address
- 300 W HIGHWAY 6
WACO, TX 767124041 - Phone
- (254) 761-8500
- Fax
- (254) 761-8050
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Nursing Facility/Intermediate Care Facility | 108085 | TX | No |
| Skilled Nursing Facility | 314000000X | Skilled Nursing Facility | 108085 | TX | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001026977 | 05 | TX | N/A |
| HH2907 | 01 | N/A | BLUE CROSS BLUE SHIELD |
| 000530801 | 05 | TX | N/A |
Frequently Asked Questions
What is PROVIDENCE PARK, INC.'s NPI number?
PROVIDENCE PARK, INC.'s NPI number is 1720086655.
Which doctor has NPI number 1720086655?
The doctor with NPI number 1720086655 is PROVIDENCE PARK, INC..
What is PROVIDENCE PARK, INC.'s practice address?
PROVIDENCE PARK, INC.'s practice address is 300 W HIGHWAY 6, WACO, TX, 767124041.
Which doctor practices at 300 W HIGHWAY 6, WACO, TX, 767124041?
PROVIDENCE PARK, INC. practices at 300 W HIGHWAY 6, WACO, TX, 767124041.
What is PROVIDENCE PARK, INC.'s phone number?
PROVIDENCE PARK, INC.'s phone number is (254) 761-8500.
Who is (254) 761-8500?
(254) 761-8500 is the phone number for PROVIDENCE PARK, INC..
What is PROVIDENCE PARK, INC.'s specialty?
PROVIDENCE PARK, INC.'s specialty is Skilled Nursing Facility.
What type of doctor is PROVIDENCE PARK, INC.?
PROVIDENCE PARK, INC. is a Skilled Nursing Facility.
Is PROVIDENCE PARK, INC. a Skilled Nursing Facility?
Yes, PROVIDENCE PARK, INC. is a Skilled Nursing Facility.
Is PROVIDENCE PARK, INC. still practicing?
Yes, PROVIDENCE PARK, INC. is currently practicing.
Is PROVIDENCE PARK, INC. accepting new patients?
PROVIDENCE PARK, INC. may be accepting new patients. Please call their office at (254) 761-8500 to inquire about availability.
Is NPI 1720086655 still active?
Yes, NPI 1720086655 is currently active.
Where does PROVIDENCE PARK, INC. practice?
PROVIDENCE PARK, INC. practices in WACO, TX.