Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Park, Inc

Organization Nursing Facility/Intermediate Care Facility · NPI 1720086655

Providence Park, Inc is a Nursing Facility/Intermediate Care Facility in Waco, Texas. Licensed in Texas. Registered with an NPI since 2005.

Licensed in
TX
In the registry since
2005
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 W Highway 6
Waco, TX 76712-4041
Phone: (254) 761-8500
Fax: (254) 761-8050
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 108085 (TX)
Nursing Facility/Intermediate Care Facility Taxonomy 313M00000X · Licence 108085 (TX)

Record details

NPI number1720086655
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Erin Shadbolt — Ceo · (314) 729-3500
Other names Ascension Living Providence Village; Ascension Living Providence Village; St. Catherine Center
NPI enumeratedJuly 13, 2005
Last updated in NPPESJune 23, 2025
Certification dateJune 23, 2025
Mailing address300 W Highway 6, Waco, TX 76712-4041

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