| NPI | 1710431861 |
|---|---|
| Doing Business As | PROVO REHABILITATION AND NURSING |
| Entity Type | Organization |
| Authorized Contact | SOON BURNAM Treasurer Of Management Company 949-540-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2021-03-02 |