Organization
REVERA (DELAWARE) LLC
Active
Other names
Montesano 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
800 N. MEDCALF, MONTESANO, WA 98563-1318
(360) 249-2273
(360) 249-2363
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
050005680
WA
314000000X
Skilled Nursing Facility
Primary
1369
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113692
—
WA
Enumeration date
10/11/2005
Last updated
05/20/2011
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