NPIMap

Organization Active NPI

Provident Health Care L.L.C

  • Nursing Facility/Intermediate Care Facility
  • Merced, CA
National Provider Identifier
1982853131
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
N.A
Legal business name
PROVIDENT HEALTH CARE L.L.C
Practice address
1238 Catalina Dr
Merced, CA 95348-9515
Phone
(408) 828-6527
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Authorized official

Name
Mr. Jerry R. Tiu
Title
Administrator
Phone
(209) 723-4888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X N.A Primary

Addresses

Primary practice location

1238 Catalina Dr
Merced, CA 95348-9515

Mailing address

4092 St Tropez CT
Merced, CA 95348-9539
Phone (209) 723-4888

National Provider Directory

National Provider Directory
Tax ID family
Provident Health Care Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1982853131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4092 ST TROPEZ CT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489539",
            "telephone_number": "209-723-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 CATALINA DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489515",
            "telephone_number": "408-828-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT HEALTH CARE L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "TIU",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-723-4888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": "N.A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.