PROVIDENT MEMORY CARE CENTER
NPI 1992136626
Alzheimer Center (Dementia Center) in Livingston, TX

Q: What is Provident Memory Care Group, LLC's NPI number?

The NPI number for Provident Memory Care Group, LLC is 1992136626. It was assigned to this organization in the NPPES registry on December 5, 2013. The provider is doing business as Provident Memory Care Center.

Q: What is Provident Memory Care Group, LLC's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Active since December 05, 2013CLIA 45D2169894 · Waiver

1810 N WASHINGTON AVE, LIVINGSTON, TX 77351(936) 327-8195 Get Directions Write a Review

NPPES record last updated: March 18, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Provident Memory Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENT MEMORY CARE CENTER (NPI 1992136626) is a healthcare organization registered as an alzheimer center (dementia center) in Livingston, Texas and active in the NPI registry since December 2013. The organization holds a CLIA Waiver certificate valid through July 29, 2027, maintains a secondary practice location in Austin, and lists Melanie Gagliardo, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1992136626

Entity TypeOrganization

Primary Taxonomy311500000X

Legal Business NamePROVIDENT MEMORY CARE GROUP, LLC

Location Address1810 N WASHINGTON AVELivingston, TX 77351-2130

Mailing Address1810 N Washington AveLivingston, TX 77351-2130 · (936) 327-8195

Phone(936) 327-8195

Organization SubpartNo

Authorized OfficialMelanie GagliardoDirector Of Operations · (210) 385-5416

Enumeration DateDecember 5, 2013

Last NPPES UpdateMarch 18, 2021

NPPES CertifiedFebruary 26, 2021

✔ NPI 1992136626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities

Taxonomy Code311500000X

License✔ Licensed in TX · 102962

Definition

A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

Also ListedAssisted Living FacilityTaxonomy 310400000X · License 137498 (TX)

1810 N WASHINGTON AVE, Livingston, TX 77351

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Other Names 1

Doing Business AsProvident Memory Care Center

Secondary Practice Location 1

Location 112515 Research Blvd, Bldg 7, Suite 200BAustin, TX 78759-2228 · Phone (512) 284-9382

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2169894

Provident Memory Care · Livingston, TX

Active · expires Jul 29, 2027

CLIA Number45D2169894

Laboratory TypeAssisted Living Facility

Certificate Effective DateJuly 30, 2025

Certificate Expiration DateJuly 29, 2027

Laboratory DirectorGenevieve Gonzales

Laboratory Phone(936) 327-8195

Laboratory LocationProvident Memory Care1810 N Washington, Livingston, TX 77351

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provident Memory Care Group, LLC's NPI number?

The NPI number for Provident Memory Care Group, LLC is 1992136626. It was assigned to this organization in the NPPES registry on December 5, 2013. The provider is doing business as Provident Memory Care Center.

Where is Provident Memory Care Group, LLC located?

Provident Memory Care Group, LLC is located at 1810 N Washington Ave, Livingston, TX 77351. The listed phone number is (936) 327-8195.

What is Provident Memory Care Group, LLC's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Provident Memory Care Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2169894) is associated with this NPI, valid through July 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Provident Memory Care Group, LLC was last updated on March 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.