National Provider Identifier Database

PROVIDENCE HEALTH SERVICES OF WACO
Psychiatric Hospital

An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.


Contact Information

PROVIDENCE HEALTH SERVICES OF WACO
301 LONDONDERRY DR
WACO, TX76712-7915
Phone: 254-751-4146
Fax: 254-751-4283
Website:
Specialty Taxonomy Code
* Psychiatric Hospital 283Q00000X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH SERVICES OF WACO

NPI Number 1033436407
Legal business name
LBN
PROVIDENCE HEALTH SERVICES OF WACO
Authorized official CRAIG CORDOLA - (CEO)
Entity Organization
Organization subpart No
Enumeration date 04/26/2010
Last updated 11/21/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • TX License #: 000040

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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