OrganizationActive
Providence Senior Home LLC
NPI 1134520463 · Health Maintenance Organization · Spokane, WA
Provider details
- NPI number
- 1134520463
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Sandu Codreanu, Owner/Provider(509) 638-8738
- License
- A752165 (WA)
Specialties & taxonomies
Managed Care Organizations
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3623 W Indian Trail Rd
Spokane, WA 99208
Phone: (509) 710-2776
Street-level locationGet directions
Mailing address
3623 W Indian Trail Rd
Spokane, WA 99208-4733
Registry dates
- Enumerated
- 2014-09-05
- Last updated
- 2014-09-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.