| NPI | 1710210117 |
|---|---|
| Doing Business As | PROVO REHABILITATION AND NURSING |
| Entity Type | Organization |
| Authorized Contact | SOON BURNAM Treasurer Of Management Company 949-487-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: UT 2010-NCF-91652) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2016-06-03 |