Organization
PROVIDENCE HEALTH SERVICES OF WACO
Active
Other names
DePaul Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN A RICHARDSON (SENIOR VP, CFO)
(254) 751-4172
Entity
Organization
Contact information
Practice address
301 LONDONDERRY DR, WACO, TX 76712-7915
(254) 776-5970
(254) 751-4887
Mailing address
PO BOX 2589, WACO, TX 76702-2589
(254) 776-5970
(254) 751-4887
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
000736
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121831504
—
TX
Enumeration date
08/29/2005
Last updated
05/19/2010
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