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Organization

PROVIDENCE HEALTH CARE AND ASSISTED LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYCHELLE SANDERS (MANAGER)
(210) 322-9647
Entity
Organization

Contact information

Practice address
2906 FORT STOCKTON DR, KATY, TX 77449-6257
(210) 322-9647
Mailing address
2906 FORT STOCKTON DR, KATY, TX 77449-6257
(210) 322-9647

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1144811589
NPI
TX
Enumeration date
03/30/2022
Last updated
03/30/2022
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