Organization
PARK REGENCY CARE LLC
Active
Other names
Park Regency Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A MORTENSEN (SR VP FINANCE)
(714) 577-3880
Entity
Organization
Contact information
Practice address
1770 W LA HABRA BLVD, LA HABRA, CA 90631
(714) 773-0750
(562) 697-8478
Mailing address
3050 SATURN STREET, SUITE #201, BREA, CA 92821-6278
(714) 577-3880
(714) 577-3895
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55536G
—
CA
Enumeration date
09/16/2006
Last updated
08/22/2020
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