Organization · Type 2 NPI
Provident Place
Intellectual Disabilities Intermediate Care Facility · Apple Valley, CA
NPI number
1508208877
Active
Practice location
15448 Mondamon Rd
Apple Valley, CA 92307-4557
Mailing address
964 E Badillo St # 523
Covina, CA 91724-2950
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
Another provider at this address
Other intellectual disabilities intermediate care facility providers in Apple Valley
About NPI 1508208877
Provident Place's National Provider Identifier is 1508208877, issued on Jul 26, 2013. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Apple Valley, CA. The record was last updated on Jul 26, 2013.