Organization
EVERGREEN AT PARK ROYAL II, L.L.C.
Active
Parent organization
EMPRES WASHINGTON HEALTHCARE, LLC
Other names
Park Royal Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES WASHINGTON HEALTHCARE, LLC
Authorized official
BRENT WEIL (CEO AND MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
910 16TH AVE, LONGVIEW, WA 98632-2302
(360) 423-2890
(360) 577-9012
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6736
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH1336
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113361
—
WA
01
—
NH1336
STATE NH#
—
Enumeration date
09/13/2005
Last updated
01/30/2017
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