Organization
PROVIDENT MEMORY CARE GROUP, LLC
Active
Other names
Provident Memory Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE GAGLIARDO (DIRECTOR OF OPERATIONS)
(210) 385-5416
Entity
Organization
Contact information
Practice address
1810 N WASHINGTON AVE, LIVINGSTON, TX 77351-2130
(936) 327-8195
Mailing address
1810 N WASHINGTON AVE, LIVINGSTON, TX 77351-2130
(936) 327-8195
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
137498
TX
311500000X
Alzheimer Center (Dementia Center)
Primary
102962
TX
Other
Enumeration date
12/05/2013
Last updated
03/18/2021
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