NPIMap

Organization Active NPI

Providence Health Services of Waco

  • Psychiatric Hospital
  • Waco, TX
National Provider Identifier
1710970397
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
000736 Issued in TX
Legal business name
PROVIDENCE HEALTH SERVICES OF WACO
Doing business as
DePaul Center
Practice address
301 Londonderry Dr
Waco, TX 76712-7915
Phone
(254) 776-5970
Fax
(254) 751-4887
NPI assigned
Aug 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Karen A Richardson
Title
Senior VP, Cfo
Phone
(254) 751-4172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 000736 TX Primary

Addresses

Primary practice location

301 Londonderry Dr
Waco, TX 76712-7915

Mailing address

PO Box 2589
Waco, TX 76702-2589
Phone (254) 776-5970

Other identifiers 1

IdentifierTypeStateIssuer
121831504MedicaidTX

Other names 1

  • DePaul Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1710970397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2589",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767022589",
            "telephone_number": "254-776-5970",
            "fax_number": "254-751-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127915",
            "telephone_number": "254-776-5970",
            "fax_number": "254-751-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH SERVICES OF WACO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SENIOR VP, CFO",
        "authorized_official_telephone_number": "254-751-4172",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TX",
            "license": "000736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121831504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DePaul Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.