Organization
PROVIDENCE HEALTH & SERVICES
Active
Other names
d/b/a/ Providence DominiCare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOAN ELIZABETH SISCO (DIRECTOR)
(509) 935-4925
Entity
Organization
Contact information
Practice address
110 S. THIRD STREET E., CHEWELAH, WA 99109
(509) 935-4925
(509) 935-4082
Mailing address
PO BOX 1070, CHEWELAH, WA 99109-1070
(509) 935-4925
(509) 935-4082
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
IHS.FS.60259664
WA
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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