Provident Foundation - Wedgewood Terrace Llc

LBN: Provident Foundation - Wedgewood Terrace Llc
Provident Foundation - Wedgewood Terrace Llc is an health care organization with primary practice located at 2114 Vineyard Avenue , Lewiston ID 83501. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center), Respite Care Facility / Respite Care. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty. Provident Foundation - Wedgewood Terrace Llc can be contacted via phone (208) 743-4545, or through Lockwood, Debra W. via phone (225) 766-3977.

Contact Information

Primary practice address
2114 Vineyard Avenue Lewiston ID 83501
Phone: (208) 743-4545
Fax: (208) 743-2268
Website:
Map and Directions
Authorized official contact:
Name: Lockwood, Debra W.
Phone: (225) 766-3977

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X
Respite Care Facility / Respite Care 385H00000X

Profile Details

NPI number 1295228054
LBN Legal business name Provident Foundation - Wedgewood Terrace Llc
DBA Doing business as
Authorized official Lockwood, Debra W.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2018
Last updated Jun 7th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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