PROVIDENT FOUNDATION - WEDGEWOOD TERRACE LLC
NPI: 1295228054
· LEWISTON, ID 83501
· Alzheimer Center (Dementia Center)
· NPI assigned 06/07/2018
$410K
Total Medicaid Paid
Provider Details
| Authorized Official | LOCKWOOD, DEBRA (PRESIDENT & CHIEF FINANCIAL OFFICER) |
| NPI Enumeration Date | 06/07/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
95 |
$99K |
| 2020 |
122 |
$99K |
| 2023 |
117 |
$212K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5140 |
Foster care, adult; per diem |
334 |
245 |
$410K |