Organization · Type 2 NPI

Providence Home

Intellectual Disabilities Intermediate Care Facility · Arlington, TX

NPI number 1700105426 Active

Practice location

8108 Modesto Dr
Arlington, TX 76001-8545

Call (817) 715-0236 Map

Specialties and licenses

TaxonomyCodeLicense
Intellectual Disabilities Intermediate Care Facility Primary 315P00000XNone listed

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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About NPI 1700105426

Providence Home's National Provider Identifier is 1700105426, issued on May 20, 2010. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Arlington, TX. The record was last updated on May 20, 2010.