Organization
ENSIGN MONTGOMERY LLC
Active
Other names
Park View Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
3751 MONTGOMERY DR, SANTA ROSA, CA 95405-5214
(707) 525-1250
(707) 525-1080
Mailing address
3751 MONTGOMERY DR, SANTA ROSA, CA 95405-5214
(707) 525-1250
(707) 525-1080
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
010000062
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR06411I
—
CA
Enumeration date
07/18/2005
Last updated
02/17/2021
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