PROVIDENCE PARK, INC. – NPI #1720086655
Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
PROVIDENCE PARK, INC. is a skilled nursing facility (SNF) located in WACO, TX. NPPES has assigned the NPI number 1720086655 to PROVIDENCE PARK, INC. on July 13, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 314000000X from the Health Care Provider Taxonomy code set, which is classified as Skilled Nursing Facility.
The NPI profile was last updated on Jun 23, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE PARK, INC. below.
NPI Profile for
PROVIDENCE PARK, INC.
(about 21 years ago)
All associated names:
Ascension Living Providence Village
St. Catherine Center
WACO, TX 76712-4041 Phone: (254) 761-8500 Fax: (254) 761-8050
CEO
Phone: (314) 729-3500
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for PROVIDENCE PARK, INC.
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| other | BLUE CROSS BLUE SHIELD | HH2907 | |
| medicaid | TX | 001026977 | |
| medicaid | TX | 000530801 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 314000000X - Skilled Nursing Facility (Primary) |
TX | 108085 |
| 313M00000X - Nursing Facility/Intermediate Care Facility |
TX | 108085 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.