Organization
PROVIDENCE PARK, INC.
Active
Other names
St. Catherine Center, Ascension Living Providence Village
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN SHADBOLT (CEO)
(314) 729-3500
Entity
Organization
Contact information
Practice address
300 W HIGHWAY 6, WACO, TX 76712-4041
(254) 761-8500
(254) 761-8050
Mailing address
300 W HIGHWAY 6, WACO, TX 76712-4041
(254) 761-8500
(254) 761-8050
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
108085
TX
314000000X
Skilled Nursing Facility
Primary
108085
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000530801
—
TX
05
—
001026977
—
TX
01
—
HH2907
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/13/2005
Last updated
06/23/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us