Organization
PROVIDENCE HEALTH SERVICES OF WACO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG CORDOLA (CEO)
(512) 325-1000
Entity
Organization
Contact information
Practice address
301 LONDONDERRY DR, WACO, TX 76712-7915
(254) 751-4146
(254) 751-4283
Mailing address
PO BOX 2589, WACO, TX 76702-2589
(254) 751-4146
(254) 751-4283
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
000040
TX
Other
Enumeration date
04/26/2010
Last updated
11/21/2017
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