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Organization
MANOR PARK HEALTHCARE LLC
Active
Organization
MANOR PARK HEALTHCARE LLC
Active
Other names
Park Manor Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
1710 PLAZA WAY, WALLA WALLA, WA 99362-4362
(509) 529-4218
(509) 522-1729
Mailing address
1710 PLAZA WAY, WALLA WALLA, WA 99362-4362
(509) 529-4218
(509) 522-1729
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
NULL
314000000X
Skilled Nursing Facility
Primary
1342
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113429
—
WA
Enumeration date
07/18/2005
Last updated
05/23/2023
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