Organization
ROYAL PLAZA RETIREMENT CENTER LEWISTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY DEAN CHINN (MEMBER)
(360) 794-9020
Entity
Organization
Contact information
Practice address
2870 JUNIPER DR, LEWISTON, ID 83501-4720
(208) 746-2800
(208) 746-0164
Mailing address
2870 JUNIPER DR, LEWISTON, ID 83501-4720
(208) 746-2800
(208) 746-0164
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
003266800
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003266800
—
ID
Enumeration date
11/01/2005
Last updated
04/05/2012
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