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Organization

PARK WAVERLY HEALTHCARE LLC

Active
Other names
Park Avenue Health and Rehabilitation Center
Organization subpart
No

Provider details

NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization

Contact information

Practice address
2001 N PARK AVE, TUCSON, AZ 85719-3558
(520) 882-6151
(520) 620-1547
Mailing address
2001 N PARK AVE, TUCSON, AZ 85719-3558
(520) 882-6151
(520) 620-1547

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTC9390
AZ DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
04/29/2019
Last updated
04/29/2019
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