Organization
STEPHENS MEMORIAL HOSPITAL DISTRICT
Active
Other names
Park Village Healthcare and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (AUTHORIZED AGENT)
(949) 540-1249
Entity
Organization
Contact information
Practice address
207 E PARKERVILLE RD, DESOTO, TX 75115-6251
(972) 230-1000
(972) 230-5509
Mailing address
207 E PARKERVILLE RD, DESOTO, TX 75115-6251
(972) 230-1000
(972) 230-5509
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
111200
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5257
—
TX
Enumeration date
09/08/2005
Last updated
10/11/2021
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