| Organization Name: | PROVIDENCE HEALTH SERVICES OF WACO |
| NPI Number: | 1033436407 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN K RICHARDSON (SENIOR VP/CFO) |
| Mailing Address: | 301 Londonderry Dr Waco |
| State: | TX US |
| Postal Code: | 767127915 |
| Phone Number: | 2547514146 |
| Fax Number: | 2547514283 |
| NPI Enumeration Date: | 04/26/2010 |
| NPI Last Update Date: | 04/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283Q00000X |
| License Number: | 000040 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Psychiatric Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |