Organization
MANOR PARK HEALTHCARE LLC
Active
Other names
Park Manor Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
1710 PLAZA WAY, WALLA WALLA, WA 99362-4362
(509) 529-4218
(509) 522-1729
Mailing address
1710 PLAZA WAY, WALLA WALLA, WA 99362-4362
(509) 529-4218
(509) 522-1729
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
1342
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113429
—
WA
Enumeration date
07/18/2005
Last updated
05/23/2023
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