Organization
MASON PARK HEALTHCARE, INC.
Active
Other names
Lakeside Rehabilitation and Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (SECRETARY)
(949) 540-1249
Entity
Organization
Contact information
Practice address
210 W LACROSSE AVE, COEUR D ALENE, ID 83814-2403
(208) 664-2185
Mailing address
210 W LACROSSE AVE, COEUR D ALENE, ID 83814-2403
(208) 664-2185
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
05/27/2025
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