# PARK REGENCY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Park Regency Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184720005
- **Authorized official:** MR. MARK A MORTENSEN (SR VP FINANCE)
- **Authorized official phone:** (714) 577-3880

## Contact information

- **Practice address:** 1770 W LA HABRA BLVD, LA HABRA, CA 90631
- **Practice address phone:** (714) 773-0750
- **Practice address fax:** (562) 697-8478
- **Mailing address:** 3050 SATURN STREET, SUITE \#201, BREA, CA 92821-6278
- **Mailing address phone:** (714) 577-3880
- **Mailing address fax:** (714) 577-3895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | CA | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55536G | — | CA |