PROVIDENCE HEALTH SYSTEMS NPI 1437816659

NPI Details

PROVIDENCE HEALTH SYSTEMS is a program of all inclusive care for the elderly pace provider organization in Milwaukie, OR. The provider is a PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. PROVIDENCE HEALTH SYSTEMS NPI is 1437816659. The provider is registered as an organization entity type.

The provider's business location address is:

10330 SE 32ND AVE STE 110
MILWAUKIE, OR
ZIP 97222-596
Phone: (503) 717-3013

The provider's authorized official is Holly Daigle .
The authorized official title is Rn Cm and has the following contact phone number (503) 513-1300.

The CLIA number assigned to this NPI record is 38D2106661 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2021 and was last updated on 11/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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