Organization · Type 2 NPI

Provident Memory Care Group, LLC

Alzheimer Center (Dementia Center) · Livingston, TX

NPI number 1992136626 Active

Practice location

1810 N Washington Ave
Livingston, TX 77351-2130

Call (936) 327-8195 Map

Other practice locations

12515 Research Blvd, Bldg 7, Suite 200B, Austin, TX 78759-2228 · (512) 284-9382

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility	310400000X	137498 (TX)
Alzheimer Center (Dementia Center) Primary	311500000X	102962 (TX)

Alzheimer Center (Dementia Center): A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; …

NPI record

NPI: 1992136626
Entity type: Organization (Type 2)
Issued: Dec 5, 2013
Last updated: Mar 18, 2021
Status: Active

Other names

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Provident Memory Care Center · doing business as
Provident Memory Care Center · doing business as

Authorized official

Melanie Gagliardo
Director of Operations
(210) 385-5416

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1992136626

Provident Memory Care Group, LLC's National Provider Identifier is 1992136626, issued on Dec 5, 2013. The primary taxonomy on file is Alzheimer Center (Dementia Center) (311500000X), and the practice location is in Livingston, TX. The record was last updated on Mar 18, 2021.