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Organization
PROVIDENT MEMORY CARE GROUP, LLC
Active
Organization
PROVIDENT MEMORY CARE GROUP, LLC
Active
Other names
Provident Memory Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE GAGLIARDO (DIRECTOR OF OPERATIONS)
(210) 385-5416
Entity
Organization
Contact information
Practice address
1810 N WASHINGTON AVE, LIVINGSTON, TX 77351-2130
(936) 327-8195
Mailing address
1810 N WASHINGTON AVE, LIVINGSTON, TX 77351-2130
(936) 327-8195
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
137498
TX
311500000X
Alzheimer Center (Dementia Center)
Primary
102962
TX
Other
Enumeration date
12/05/2013
Last updated
03/18/2021
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