Organization
REVERA (DELAWARE) LLC
Active
Other names
Orchard Park Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE M SCILLIA (LLC MANAGER)
(203) 608-6100
Entity
Organization
Contact information
Practice address
4755 S 48TH STREET, TACOMA, WA 98409-1919
(253) 475-4611
(253) 471-9591
Mailing address
538 PRESTON AVE, SUITE 270, MERIDEN, CT 06450-4851
(203) 608-6100
(203) 639-3574
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1259
WA
314000000X
Skilled Nursing Facility
NH1259
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112595
—
WA
Enumeration date
11/02/2005
Last updated
05/20/2011
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